Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 6301013744 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301013744 | MI |
NPI | 1013149590 |
---|---|
Provider Name | Amanda Sue-Weishuhn Harris |
First Address | Ann Arbor, MI 48104-1397 |
Second Address | Ann Arbor, MI 48104-1397 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2009 |
Last Update Date | 11/12/2013 |