Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 6351002678 | MI |
Y | 103TC0700X | Clinical Psychologist | 6351002678 | MI |
NPI | 1003432188 |
---|---|
Provider Name | Demaree K Josephon |
First Address | Howell, MI 48843-7418 |
Second Address | Farmington Hills, MI 48334-4424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2020 |
Last Update Date | 24/06/2020 |