Healthcare Provider Details

I. General information

NPI: 1316494545
Provider Name (Legal Business Name): DAVIA BETH STEINBERG OGG PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAVIA BETH STEINBERG

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 10/23/2021
Certification Date: 10/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N 5TH AVE STE 230
ANN ARBOR MI
48104-5504
US

IV. Provider business mailing address

79 W ALEXANDRINE ST
DETROIT MI
48201-2015
US

V. Phone/Fax

Practice location:
  • Phone: 734-215-5366
  • Fax:
Mailing address:
  • Phone: 313-831-5535
  • Fax: 313-831-2608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301018946
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: