MEDICARE: MICHELE VALERIE VARADY

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
1	103TC0700X	Clinical Psychologist	6301017059	MI

General Provider Information

NPI Number	:	1700389418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE VALERIE VARADY

Provider Business Mailing Address
First Line	:	54 WOODWARD HEIGHTS BLVD
Second Line	:
City	:	PLEASANT RIDGE
State	:	MI
Zip	:	48069-1247
Country	:	US
Telephone Number	:	248-219-8829
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 N OLD WOODWARD AVE STE 300
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-1338
Country	:	US
Telephone Number	:	248-642-8263
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2018
Last Update Date	:	03/09/2018

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Directions to “ MICHELE VALERIE VARADY ” Practice Location

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