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General NPI Number Information
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NPI Number | 1255779492
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Entity Type | Individual
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Provider Name | HEATHER D HAGGERTY PSYD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2013
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 215 ANN ARBOR RD W STE 206
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City | PLYMOUTH
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State | MI
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Zip | 48170-2251
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Country | US
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Telephone | 248-346-4999
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 104
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City | UNION LAKE
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State | MI
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Zip | 48387-0104
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Country | US
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Telephone | 248-346-4999
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301015106
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License Number State | MI
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