Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 6301012058 | MI |
N | 101YM0800X | Mental Health Counselor | 630102508 | MI |
N | 102L00000X | Psychologist | 6301012058 | MI |
N | 103T00000X | Psychologist | 6301012058 | MI |
Y | 102L00000X | Psychologist | 630102058 | MI |
Y | 103T00000X | Psychologist | 630102058 | MI |
N | 102L00000X | Psychologist | DG012058 | MI |
N | 103T00000X | Psychologist | DG012058 | MI |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 6301012058 | MI |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 630102508 | MI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 6301012058 | MI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 630102508 | MI |
NPI | 1205843794 |
---|---|
Provider Name | Ms. Deena M Guice |
First Address | Royal Oak, MI 48067-3349 |
Second Address | Novi, MI 48375-2459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 18/07/2015 |