Individual
ANTHONIA OLAYINKA GANSALLO-LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2399 E WALTON BLVD, AUBURN HILLS, MI 48326-1955
(248) 475-6300
Mailing address
2399 E WALTON BLVD, AUBURN HILLS, MI 48326-1955
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
Primary
6352000651
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/11/2016
Last updated
03/25/2026
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