Most Relevant Information
Provider Data
| NPI Number: | 1003390600 |
| Provider Name: | EBONY LATRESE BERTELSMEYER |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/19/2018 |
| Last Updated: | 01/14/2020 |
Provider Practice Location
1450 S LAPEER RD
OXFORD
MI
483716108
Practice Location Phone/Fax
| Phone: | 4896999322 |
| Fax: | 2489690840 |
Provider Mailing Location
1450 S LAPEER RD
OXFORD
MI
483716108
Provider Mailing Phone/Fax
| Phone: | 2489699932 |
| Fax: | 2489690840 |