Healthcare Provider Details

I. General information

NPI: 1225164577
Provider Name (Legal Business Name): TANYA PAULA SHREM PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E LONG LAKE RD STE 375
BLOOMFIELD HILLS MI
48304-2377
US

IV. Provider business mailing address

300 EAST LONG LAKE RD SUITE 375
BLOOMFIELD HILLS MI
48304-2374
US

V. Phone/Fax

Practice location:
  • Phone: 248-788-7081
  • Fax: 248-737-9963
Mailing address:
  • Phone: 248-788-7081
  • Fax: 248-737-9963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301010632
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: