Healthcare Provider Details

I. General information

NPI: 1730561515
Provider Name (Legal Business Name): DEXTER PSYCHOLOGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 3RD ST
ANN ARBOR MI
48103-4304
US

IV. Provider business mailing address

211 3RD ST
ANN ARBOR MI
48103-4304
US

V. Phone/Fax

Practice location:
  • Phone: 734-395-9380
  • Fax:
Mailing address:
  • Phone: 734-395-9380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301015743
License Number StateMI

VIII. Authorized Official

Name: DR. MARIANNE ELIZABETH WISHKA
Title or Position: LICENSED PSYCHOLOGIST/FOUNDER
Credential: PSYD, LP
Phone: 734-395-9380