Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 6301015493 | MI |
Y | 103T00000X | Psychologist | 6301015493 | MI |
NPI | 1013319987 |
---|---|
Provider Name | Dr. Brittney Devine Walsh |
First Address | Detroit, MI 48219-3165 |
Second Address | Detroit, MI 48219-3165 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2014 |
Last Update Date | 22/07/2020 |