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General NPI Number Information
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NPI Number | 1932573383
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Entity Type | Organization
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Legal Business Name | DONNA MARIE D. MESZAROS, PH.D., LP PLLC
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 37677 PROFESSIONAL CENTER DR SUITE 125C
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City | LIVONIA
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State | MI
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Zip | 48154-1192
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Country | US
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Telephone | 734-751-2921
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Fax |
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Provider Business Mailing Address
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Address Line | 46417 KILLARNEY CIR
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City | CANTON
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State | MI
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Zip | 48188-3501
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Country | US
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Telephone | 734-751-2921
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DONNA MARIE D. MESZAROS
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Credential | PH.D.
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Telephone | 734-751-2921
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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 | 6301009817
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License Number State | MI
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