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General NPI Number Information
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NPI Number | 1013213735
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Entity Type | Organization
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Legal Business Name | LINDA AARDEMA PSY S PLLC
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 950 E MAPLE RD SUITE 205
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6408
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Country | US
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Telephone | 248-540-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 950 E MAPLE RD SUITE 205
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6408
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Country | US
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Telephone | 248-540-4242
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MISS SHELLEY A TAGLIONE
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Credential |
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Telephone | 734-414-0754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301005752
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License Number State | MI
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