Healthcare Provider Details

I. General information

NPI: 1902923477
Provider Name (Legal Business Name): CAROLYN RENE ARKING M.A., L.L.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10299 GRAND RIVER RD SUITE I
BRIGHTON MI
48116-6541
US

IV. Provider business mailing address

4149 SONATA DR
HOWELL MI
48843-5207
US

V. Phone/Fax

Practice location:
  • Phone: 810-844-7300
  • Fax: 810-227-0267
Mailing address:
  • Phone: 810-844-7323
  • Fax: 810-227-0267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301009167
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: