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General NPI Number Information
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NPI Number | 1104215680
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Entity Type | Organization
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Legal Business Name | PERCEPTIONS THERAPY L.L.C.
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Dates
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Enumeration Date | 01/21/2015
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Last Update Date | 02/15/2016
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Provider Practice Location Address
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Address Line | 15360 23 MILE RD
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City | MACOMB
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State | MI
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Zip | 48044-1000
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Country | US
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Telephone | 586-992-6090
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Fax | 586-992-6091
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Provider Business Mailing Address
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Address Line | 15360 23 MILE RD
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City | MACOMB
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State | MI
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Zip | 48044-1000
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Country | US
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Telephone | 586-992-6090
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Fax | 586-992-6091
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. SAMANTHIA Z ZOLNOSKI
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Credential | MA TLLP
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Telephone | 586-275-8191
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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 | 6301015090
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License Number State | MI
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