Healthcare Provider Details

I. General information

NPI: 1962259473
Provider Name (Legal Business Name): MANUELA ALMEIDA VIVEIROS SA LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 02/01/2026
Certification Date: 02/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8898 COMMERCE RD STE 3
COMMERCE TOWNSHIP MI
48382-4485
US

IV. Provider business mailing address

1384 DEVON LN
TROY MI
48084-7045
US

V. Phone/Fax

Practice location:
  • Phone: 734-404-8623
  • Fax: 947-777-7008
Mailing address:
  • Phone: 248-515-8922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6361008286
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: