Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 6401015823 | MI |
NPI | 1073107645 |
---|---|
Provider Name | Ms. Leah Faleer Marcus |
First Address | Ann Arbor, MI 48108-3216 |
Second Address | Ann Arbor, MI 48108-3216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2021 |
Last Update Date | 24/02/2021 |