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Tiffany Derksen, TLLP

Psychologist, Clinical in Brighton, MI. Individual provider (NPI-1).

NPI number1104477652
StatusActive
Last updated in NPPESSep 26, 2019

Details

NPI
1104477652
Entity type
Individual (NPI-1)
Name
Tiffany Derksen
Credential
TLLP
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 26, 2019
Last updated
Sep 26, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103TC0700X Psychologist, Clinical6301018112MIYes

Practice location

7305 Grand River Rd Ste 300
Brighton, MI 48114-7378

Phone 734-961-7196 · Fax 734-961-7187

Mailing address

7305 Grand River Rd Ste 300
Brighton, MI 48114-7378

Phone 734-961-7196 · Fax 734-961-7187

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