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General NPI Number Information
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NPI Number | 1497053102
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Entity Type | Organization
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Legal Business Name | FAMILY PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 2040 INTERTOWN RD
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City | PETOSKEY
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State | MI
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Zip | 49770-9746
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Country | US
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Telephone | 231-347-7665
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Fax | 231-348-0904
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Provider Business Mailing Address
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Address Line | 2040 INTERTOWN RD
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City | PETOSKEY
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State | MI
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Zip | 49770-9746
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Country | US
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Telephone | 231-347-7665
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Fax | 231-348-0904
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. MARIA TERESA DAUNTER
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Credential | PH.D.
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Telephone | 231-347-7665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 005398
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License Number State | MI
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