Individual
ALEXANDRIA JERICHOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, TLLP
Contact information
Practice address
42500 HAYES RD STE 500, CLINTON TOWNSHIP, MI 48038-6768
(586) 828-1221
Mailing address
8505 CHESTERFIELD DR, SWARTZ CREEK, MI 48473-1272
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
630101787
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14473184
—
MI
Enumeration date
05/23/2019
Last updated
05/23/2019
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