| Doctor Name: | MARY ROSE GIROUX |
| NPI Number: | 1730564055 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | TLLP |
| License Number: | 6301016361 |
| Business Practice Address: | 22516 Overlake St St. Clair Shores, MI - 48080 |
| Business Phone Number: | 7243533682 |
| Business Fax Number: | |
| Mailing Address: | 22516 Overlake St, SAINT CLAIR SHORES |
| State: | MI |
| Postal Code: | 480803852 |
| Phone Number: | 7343533682 |
| Fax Number: | |
| NPI Enumeration Date: | 07/28/2015 |
| NPI Last Update Date: | 07/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301016361 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |