Healthcare Provider Details

I. General information

NPI: 1578856258
Provider Name (Legal Business Name): ROBERT PAPAZIAN, PSY.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2011
Last Update Date: 05/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 KERCHEVAL AVE SUITE 390
GROSSE POINTE FARMS MI
48236-3629
US

IV. Provider business mailing address

131 KERCHEVAL AVE SUITE 390
GROSSE POINTE FARMS MI
48236-3629
US

V. Phone/Fax

Practice location:
  • Phone: 313-885-6400
  • Fax: 313-885-6807
Mailing address:
  • Phone: 313-885-6400
  • Fax: 313-885-6807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301008048
License Number StateMI

VIII. Authorized Official

Name: MR. ROBERT A PAPAZIAN
Title or Position: OWNER
Credential: PSY.D.
Phone: 313-885-0052