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General NPI Number Information
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NPI Number | 1013232529
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Entity Type | Organization
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Legal Business Name | CHERYL LYNN PODOLSKI PHD PLLC
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 339 N CENTER ST
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City | NORTHVILLE
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State | MI
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Zip | 48167-1288
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Country | US
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Telephone | 248-974-6449
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Fax |
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Provider Business Mailing Address
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Address Line | 313 ELY DR S
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City | NORTHVILLE
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State | MI
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Zip | 48167-2729
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Country | US
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Telephone | 248-974-6449
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. CHERYL LYNN PODOLSKI
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Credential | PH.D.
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Telephone | 248-974-6449
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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