Healthcare Provider Details
I. General information
NPI: 1235167248
Provider Name (Legal Business Name): KATHLEEN K RYCHTER MA, LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17250 FARMINGTON RD
LIVONIA MI
48152-3151
US
IV. Provider business mailing address
28000 DEQUINDRE RD
WARREN MI
48092-2468
US
V. Phone/Fax
- Phone: 734-425-4070
- Fax: 734-425-8350
- Phone: 586-753-0405
- Fax: 586-753-0404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 6301008137 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: