Provider Information for 1114361979
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Dr. TERRI LYNNE BELVILLE-ROBERTSON PhD
Sex: Female
NPI: 1114361979
Last Updated: 2013-04-24
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1114361979 | ||||||||
| Enumeration Date | 2013-04-24 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1 FORD PL 3A DETROIT, MI 48202-3450 United States Phone: 313-874-2495 | Fax:313-874-9515 | ||||||||
| Primary Practice Address | 29200 SCHOOLCRAFT RD LIVONIA, MI 48150-2228 United States Phone: 734-523-8650 | Fax:734-523-2419 | ||||||||
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