| Doctor Name: | MICHELLE E MASTIN |
| NPI Number: | 1003869116 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 6301012872 |
| Business Practice Address: | 1600 7th Ave S Birmingham, AL - 352331711 |
| Business Phone Number: | 2056389461 |
| Business Fax Number: | |
| Mailing Address: | 1600 7th Ave S, BIRMINGHAM |
| State: | AL |
| Postal Code: | 352331711 |
| Phone Number: | 2056389461 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 06/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 6301012872 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |