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NPI Code Detail

MEDICARE: PAULINA MULTHAUPT

MEDICARE: PAULINA MULTHAUPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist6301010352MI
2103TC0700XClinical Psychologist6301010352MI

General Provider Information

NPI Number : 1417489402
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULINA MULTHAUPT
Provider Business Mailing Address
First Line : 15125 22 MILE RD
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48315-4406
Country : US
Telephone Number : 586-532-0599
Fax Number : 586-566-8967
Provider Business Practice Location Address
First Line : 15125 22 MILE RD
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48315-4406
Country : US
Telephone Number : 586-532-0599
Fax Number : 586-566-8967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2017
Last Update Date : 03/30/2017

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Directions to “ PAULINA MULTHAUPT ” Practice Location

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