Provider Demographics
NPI:1326290602
Name:BELZ, SANDRA (MA, LLP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:BELZ
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:FRIEDRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LLP
Mailing Address - Street 1:5331 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9520
Mailing Address - Country:US
Mailing Address - Phone:734-996-9111
Mailing Address - Fax:734-996-1950
Practice Address - Street 1:5331 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9520
Practice Address - Country:US
Practice Address - Phone:734-996-9111
Practice Address - Fax:734-996-1950
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013403103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist