Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 6301002503 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301002503 | MI |
NPI | 1003829904 |
---|---|
Provider Name | Dr. Shirley Tighe Frank |
First Address | East Lansing, MI 48823 |
Second Address | East Lansing, MI 48823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 08/07/2007 |