NPI 1003116658
Michael Eugene Wallace, MA
Practice location
- Address
- 201 E Liberty St Suite 2, Ann Arbor, MI 48104-2118
- Phone
- (734) 330-3580
- Mailing address
- 201 E. Liberty St. Suite 2, Ann Arbor, MI 48104
Registered specialties
Clinical Psychologist
Primary
Registry record
- NPI
- 1003116658
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 29 Oct 2010
- Record last updated
- 29 Oct 2010
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.