Dr. Maritaconstance Supan
Clinical Psychologist Clinical Child & Adolescent Psychologist
934 Mason St
Dearborn
, Michigan 48124-2215
Dr. Maritaconstance Supan
Clinical Psychologist Clinical Child & Adolescent Psychologist
934 Mason St
Dearborn
, Michigan 48124-2215
(313) 278-8053
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About
Features
Specialties
- Clinical Psychologist
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Dr. Maritaconstance Supan
- 934 Mason St
- Dearborn, MI
- Zip : 48124-2215
- Fax : (313) 278-8053
- Phone : (313) 278-8053
Second Address
- Dr. Maritaconstance Supan
- 934 Mason St
- Dearborn, MI
- Zip : 48124-2215
- Fax : (313) 278-8053
- Phone : (313) 278-8053
Reviews
FAQs
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Where did Dr. Maritaconstance Supan do her fellowship?
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What type of doctor is Dr. Maritaconstance Supan
In what state does Dr. Maritaconstance Supan practice in?
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What is Dr. Maritaconstance Supan ’s gender?
Is Dr. Maritaconstance Supan a sole practitioner?
Is Dr. Maritaconstance Supan accepting new patients?
What languages does Dr. Maritaconstance Supan speak?
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Does Dr. Maritaconstance Supan have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 6301008934 | MI |
| Y | 103TC0700X | Clinical Psychologist | 6301008934 | MI |
| N | 103TC2200X | Clinical Child & Adolescent Psychologist | 6301008934 | MI |
National Provider Identifier
| NPI | 1063663714 |
|---|---|
| Provider Name | Dr. Maritaconstance Supan |
| First Address | Dearborn, MI 48124-2215 |
| Second Address | Dearborn, MI 48124-2215 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/09/2008 |
| Last Update Date | 30/09/2008 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.