Healthcare Provider Details

I. General information

NPI: 1346376167
Provider Name (Legal Business Name): JOHN LEONARD SCHIPPERS LLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 E ELLSWORTH RD
ANN ARBOR MI
48108-2552
US

IV. Provider business mailing address

195 W WARNER ST
YPSILANTI MI
48197-4709
US

V. Phone/Fax

Practice location:
  • Phone: 734-222-3500
  • Fax: 734-971-2487
Mailing address:
  • Phone: 347-255-9306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6361005430
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301011477
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: