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General NPI Number Information
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NPI Number | 1215115100
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Entity Type | Individual
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Provider Name | AMY JO GUYTON M.A.,LLP
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Gender | Female
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 424 W 5TH ST SUITE#210
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City | ROYAL OAK
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State | MI
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Zip | 48067-2545
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Country | US
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Telephone | 734-657-4552
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Fax |
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Provider Business Mailing Address
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Address Line | 753 WATERSEDGE DR
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City | ANN ARBOR
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State | MI
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Zip | 48105-2516
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Country | US
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Telephone | 734-657-4552
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301009007
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License Number State | MI
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