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General NPI Number Information
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NPI Number | 1093705923
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Entity Type | Individual
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Provider Name | JOANNE KAREN SCHOUTEN I PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/22/2005
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 18450 RIVERSIDE DR
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-3125
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Country | US
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Telephone | 248-563-9825
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Fax | 248-566-3036
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Provider Business Mailing Address
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Address Line | 18450 RIVERSIDE DR
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-3125
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Country | US
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Telephone | 248-563-9825
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Fax | 248-566-3036
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301006461
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License Number State | MI
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