Wise Mind PLLC
Psychologist, Clinical in Ypsilanti, MI. Organization (NPI-2).
NPI number1982147302
StatusActive
Last updated in NPPESFeb 14, 2022
Details
- NPI
- 1982147302
- Entity type
- Organization (NPI-2)
- Legal business name
- Wise Mind PLLC
- Organization subpart
- No
- Enumeration date
- Dec 2, 2016
- Certification date
- Feb 14, 2022
- Last updated
- Feb 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | – | – | Yes |
Practice location
127 N Washington StYpsilanti, MI 48197-2619
Phone 734-682-5544
Mailing address
127 N Washington StYpsilanti, MI 48197-2619
Phone 734-682-5544
Authorized official
Antoinette Crocilla
Psychologist/Owner
5174990991
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