Healthcare Provider Details
I. General information
NPI: 1952228223
Provider Name (Legal Business Name): PALE BLUE DOT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
541 PEARSON ST APT 1
FERNDALE MI
48220-2892
US
IV. Provider business mailing address
34705 W 12 MILE RD STE 160
FARMINGTON HILLS MI
48331-3282
US
V. Phone/Fax
- Phone: 248-697-2597
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARA
PIERCE
Title or Position: OWNER/THERAPIST
Credential: LLP
Phone: 248-622-1016