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General NPI Number Information
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NPI Number | 1396894424
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Entity Type | Organization
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Legal Business Name | CHRISTINA HAEMMERLE PHD PC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 11/13/2010
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Provider Practice Location Address
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Address Line | 2565 S ROCHESTER RD SUITE 108B
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-4472
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Country | US
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Telephone | 248-852-7907
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Fax |
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Provider Business Mailing Address
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Address Line | 55680 LANCEWOOD DR
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-5808
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Country | US
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Telephone | 586-207-1069
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTINA HAEMMERLE
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Credential | PH.D.
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Telephone | 586-321-8115
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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 | 6301010779
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License Number State | MI
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