Individual
REX R SKUPIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
TLLP
Contact information
Practice address
1035 E WILCOX AVE, WHITE CLOUD, MI 49349-8794
(231) 689-5943
(231) 689-1590
Mailing address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-5045
(231) 745-5031
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301016756
MI
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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