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Contact Information

CHRISTINE B WILSON DE MEDINA, M.S.,L.L.P.
W-4111 ANDOVER ROAD
BLOOMFIELD HILLS, MI48302
 Phone: 248-290-5400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for CHRISTINE B WILSON DE MEDINA · (Female)

NPI Number 1144887936
Status Active
Credentials M.S.,L.L.P.
Entity Individual
Enumeration date 05/28/2019
Last updated 05/28/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • MI License # L915934
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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