Healthcare Provider Details

I. General information

NPI: 1356594956
Provider Name (Legal Business Name): GAIL ANN KAYE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30100 TELEGRAPH RD SUITE 477
BINGHAM FARMS MI
48025-4514
US

IV. Provider business mailing address

6930 PEBBLE CREEK WOODS DRIVE
WEST BLOOMFIELD MI
48322
US

V. Phone/Fax

Practice location:
  • Phone: 248-626-0677
  • Fax:
Mailing address:
  • Phone: 248-626-0677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301010014
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number6301010014
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number6301010014
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301010014
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6301010014
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number6301010014
License Number StateMI
# 7
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number6301010014
License Number StateMI
# 8
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number6301010014
License Number StateMI
# 9
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number6301010014
License Number StateMI
# 10
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number6301010014
License Number StateMI
# 11
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number6301010014
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: