Healthcare Provider Details

I. General information

NPI: 1912330515
Provider Name (Legal Business Name): ERIN KATHLINE RYCHLICK MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 09/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 S SAGINAW ST SUITE 1460
FLINT MI
48507-2645
US

IV. Provider business mailing address

585 JEWETT RD
MASON MI
48854-8729
US

V. Phone/Fax

Practice location:
  • Phone: 810-237-0799
  • Fax: 810-237-0805
Mailing address:
  • Phone: 517-676-5405
  • Fax: 517-676-5460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301015654
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number6301015654
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: