Healthcare Provider Details
I. General information
NPI: 1811882558
Provider Name (Legal Business Name): YPSILANTI PSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
275 S WALLACE BLVD
YPSILANTI MI
48197-4678
US
IV. Provider business mailing address
275 S WALLACE BLVD
YPSILANTI MI
48197-4678
US
V. Phone/Fax
- Phone: 734-789-4658
- Fax:
- Phone: 503-459-9525
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0004X |
| Taxonomy | Health Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ERINN
CAMERON
Title or Position: OWNER AND CLINICAL LEAD
Credential: PHD
Phone: 503-459-9525