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General NPI Number Information
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NPI Number | 1265759633
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PSYCHOLOGICAL AND ASSESSMENT SERVICES LLC
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 04/14/2011
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Provider Practice Location Address
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Address Line | 1387 E M 89
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City | OTSEGO
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State | MI
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Zip | 49078-9301
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Country | US
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Telephone | 269-692-2100
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Fax | 269-692-2101
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Provider Business Mailing Address
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Address Line | 1387 E M 89
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City | OTSEGO
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State | MI
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Zip | 49078-9301
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Country | US
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Telephone | 269-998-2728
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMBER M BURNETT
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Credential | PSYD
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Telephone | 269-998-2728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6401009350
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6301014241
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License Number State | MI
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