Healthcare Provider Details

I. General information

NPI: 1124254792
Provider Name (Legal Business Name): CAMEY SPRINGER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAMEY JEWELL MA

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 11/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13101 ALAN RD
SOUTHGATE MI
48195-2216
US

IV. Provider business mailing address

20948 RIDGEMONT RD
HARPER WOODS MI
48225-1168
US

V. Phone/Fax

Practice location:
  • Phone: 734-785-7700
  • Fax:
Mailing address:
  • Phone: 586-863-2956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number823069
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: