Supan, Maritaconstance
Supan, Maritaconstance is an sole proprietor health care provider with primary practice located at 934 Mason St , Dearborn MI 48124-2215. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Supan, Maritaconstance can be contacted via phone (313) 278-8053.Contact Information
Primary practice address
934 Mason St
Dearborn MI 48124-2215
Phone: (313) 278-8053
Fax: (313) 278-8053
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301008934 | Michigan |
Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 6301008934 | Michigan |
Profile Details
NPI number | 1063663714 |
---|---|
LBN Legal business name | Supan, Maritaconstance |
Credentials | PH.D., LLP, DAPA |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 30th, 2008 |
Last updated | Sep 30th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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