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General NPI Number Information
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NPI Number | 1093422271
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Entity Type | Individual
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Provider Name | DENNIS SURHIGH
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Gender | Male
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Dates
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Enumeration Date | 10/28/2022
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 1685 BALDWIN AVE
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City | PONTIAC
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State | MI
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Zip | 48340-1242
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Country | US
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Telephone | 248-706-3450
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Fax |
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Provider Business Mailing Address
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Address Line | 31658 MARY ANN DR
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City | WARREN
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State | MI
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Zip | 48092-5025
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Country | US
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Telephone | 586-943-4558
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401012312
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License Number State | MI
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