MEDICARE: JARRID DONOVAN MA, T-LLP

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	103T00000X	Psychologist	6361008217	MI

General Provider Information

NPI Number	:	1710739941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARRID DONOVAN MA, T-LLP

Provider Business Mailing Address
First Line	:	32813 MIDDLEBELT RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-1702
Country	:	US
Telephone Number	:	248-702-4546
Fax Number	:

Provider Business Practice Location Address
First Line	:	32813 MIDDLEBELT RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-1702
Country	:	US
Telephone Number	:	248-702-4546
Fax Number	:

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

Provider Enumeration Date	:	04/02/2024
Last Update Date	:	08/11/2025

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