Healthcare Provider Details

I. General information

NPI: 1962149302
Provider Name (Legal Business Name): EVAN PATRICK ARROWOOD SCHOOL PSYCHOLOGIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 GROVE RD
YPSILANTI MI
48198-9301
US

IV. Provider business mailing address

555 W COLUMBIA AVE
BELLEVILLE MI
48111-3999
US

V. Phone/Fax

Practice location:
  • Phone: 734-482-9845
  • Fax:
Mailing address:
  • Phone: 734-697-9123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPP0000001248210
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: