Individual
JENNIFER DESCHRYVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
4120 W MAPLE RD, SUITE 101, BLOOMFIELD HILLS, MI 48301-3010
(248) 890-4077
(248) 855-4530
Mailing address
18915 DORIS ST, LIVONIA, MI 48152-1921
(248) 890-4077
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301011358
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301011358
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68-0-F3-0385-0
BCBS
MI
Enumeration date
12/07/2007
Last updated
09/23/2010
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