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General NPI Number Information
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NPI Number | 1013136514
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Entity Type | Individual
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Provider Name | M KERRIE DELEVIE
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Gender | Female
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 7151 N MAIN ST # 100
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City | CLARKSTON
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State | MI
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Zip | 48346-1582
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Country | US
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Telephone | 248-922-7419
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Fax |
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Provider Business Mailing Address
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Address Line | 4444 RYANT DR
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City | FLINT
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State | MI
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Zip | 48507-1034
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Country | US
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Telephone | 248-249-1520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301005696
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License Number State | MI
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