Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 103TC1900X | Counseling Psychologist | 6301016901 | MI |
NPI | 1093154437 |
---|---|
Provider Name | Deborah Simpson |
First Address | Plymouth, MI 48170-3869 |
Second Address | Plymouth, MI 48170-3869 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2013 |
Last Update Date | 27/03/2019 |