Healthcare Provider Details

I. General information

NPI: 1770751133
Provider Name (Legal Business Name): NANCY PESCH L.L.P., R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 05/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30025 MUIRLAND DR
FARMINGTON HILLS MI
48334-2052
US

IV. Provider business mailing address

30025 MUIRLAND DR
FARMINGTON HILLS MI
48334-2052
US

V. Phone/Fax

Practice location:
  • Phone: 248-421-2003
  • Fax: 248-421-2003
Mailing address:
  • Phone: 248-421-2003
  • Fax: 248-421-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: