Provider Information for 1073769303
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Ms. IRENE DESPO KYPRIANIDES LMSW
Sex: Female
NPI: 1073769303
Last Updated: 2012-06-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1073769303 | ||||||||
| Enumeration Date | 2008-08-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 21885 DUNHAM RD STE 1 CLINTON TWP, MI 48036-1030 United States Phone: 586-469-7714 | Fax: | ||||||||
| Primary Practice Address | 21885 DUNHAM RD STE 1 CLINTON TWP, MI 48036-1030 United States Phone: 586-469-7714 | Fax: | ||||||||
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