Individual
SUSAN I LEITMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
36880 WOODWARD AVE, SUITE 205, BLOOMFIELD HILLS, MI 48304-0919
(248) 258-1650
(248) 647-1572
Mailing address
36880 WOODWARD AVE, SUITE 205, BLOOMFIELD HILLS, MI 48304-0919
(248) 258-1650
(248) 647-1572
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301004071
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680F32547
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
05/24/2007
Last updated
07/08/2007
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