Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6301017623 | MI |
NPI | 1023585502 |
---|---|
Provider Name | Mrs. Trystyn Mccarthy |
First Address | Northville, MI 48167-1584 |
Second Address | Northville, MI 48167-1584 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2018 |
Last Update Date | 01/11/2018 |