Healthcare Provider Details

I. General information

NPI: 1932437464
Provider Name (Legal Business Name): RHONDA B. LEVY-LARSON, PH.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2009
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 ORCHARD LAKE RD STE 130
WEST BLOOMFIELD MI
48322-3605
US

IV. Provider business mailing address

7001 ORCHARD LAKE RD STE 130
WEST BLOOMFIELD MI
48322-3605
US

V. Phone/Fax

Practice location:
  • Phone: 248-709-9708
  • Fax: 248-923-1254
Mailing address:
  • Phone: 248-709-9708
  • Fax: 248-923-1254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6301006751
License Number StateMI

VIII. Authorized Official

Name: DR. RHONDA BETH LEVY-LARSON
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 248-709-9708