Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 6301016302 | MI |
NPI | 1043507759 |
---|---|
Provider Name | Dr. Aguib Diop |
First Address | Utica, MI 48317-5844 |
Second Address | Utica, MI 48317-5844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2011 |
Last Update Date | 29/12/2018 |