Healthcare Provider Details

I. General information

NPI: 1174953665
Provider Name (Legal Business Name): REPRIEVE WELL BEING CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 11/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25882 ORCHARD LAKE RD SUITE L-3
FARMINGTON HILLS MI
48336-1292
US

IV. Provider business mailing address

25882 ORCHARD LAKE RD SUITE L-3
FARMINGTON HILLS MI
48336-1292
US

V. Phone/Fax

Practice location:
  • Phone: 248-471-9644
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHY MORROW
Title or Position: OWNER
Credential:
Phone: 248-471-9644