Healthcare Provider Details

I. General information

NPI: 1952463671
Provider Name (Legal Business Name): PATRICIA ANN PLOPA PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4655 PICKERING RD
BLOOMFIELD HILLS MI
48301-3631
US

IV. Provider business mailing address

4655 PICKERING RD
BLOOMFIELD HILLS MI
48301-3631
US

V. Phone/Fax

Practice location:
  • Phone: 248-737-6417
  • Fax: 248-737-6417
Mailing address:
  • Phone: 248-737-6417
  • Fax: 248-737-6417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301 002100
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: