Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 6401000068 | MI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6301006985 | MI |
N | 104100000X | Social Worker | 6801065903 | MI |
NPI | 1003987421 |
---|---|
Provider Name | Mr. Selim Ucer |
First Address | Grand Blanc, MI 48439-1841 |
Second Address | Grand Blanc, MI 48439-1841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2006 |
Last Update Date | 08/07/2007 |