DR. MARITACONSTANCE SUPAN PH.D. LLP DAPA NPI 1063663714

NPI Information

DR. Maritaconstance Supan, PH.D., LLP, DAPA is a clinical psychologist in Dearborn, MI. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR. Maritaconstance Supan, PH.D., LLP, DAPA NPI is 1063663714. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

934 MASON ST
DEARBORN, MI
ZIP 48124-215
Phone: (313) 278-8053
Fax: (313) 278-8053

The enumeration date for this NPI number is 9/30/2008 and was last updated on 9/30/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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