Individual
MS. KRISTA MARIE CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41935 12 MILE RD., CHRILDREN'S HOSPITAL OF MI AUTISM CENTER, NOVI, MI 48377
(248) 305-6211
Mailing address
4201 ST. ANTOINE UHC 6F MAILBOX# 226, UNIVERSITY PEDIATRICIANS, DETROIT, MI 48201
(313) 966-5051
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301011361
MI
Other
Enumeration date
09/24/2009
Last updated
10/17/2014
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