Individual
MICHELLE DEWAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
127 N RIVER ST, FENTON, MI 48430-3800
(810) 309-9355
(810) 750-1152
Mailing address
127 N RIVER ST, FENTON, MI 48430-3800
(810) 309-9355
(810) 750-1152
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
63614007314
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6361007314
LICENSE
MI
Enumeration date
01/18/2022
Last updated
06/08/2023
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