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General NPI Number Information
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NPI Number | 1306071071
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Entity Type | Organization
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Legal Business Name | MANAGEMENT & BEHAVIOR CONSULTANTS, P. C.
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Dates
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Enumeration Date | 05/24/2009
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Last Update Date | 07/17/2020
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Provider Practice Location Address
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Address Line | 955 E 8TH ST STE 2
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-2785
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Country | US
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Telephone | 231-946-0299
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Fax | 231-946-9788
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Provider Business Mailing Address
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Address Line | 955 E 8TH ST STE 2
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-2785
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Country | US
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Telephone | 231-946-0299
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Fax | 231-946-9788
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROXANNE KAY FALL
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Credential | PH.D., LLP
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Telephone | 231-946-0299
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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 |
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License Number State |
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