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General NPI Number Information
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NPI Number | 1497454573
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Entity Type | Organization
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Legal Business Name | ENCORE PSYCHOLOGY SERVICES, LLC
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 33 BLOOMFIELD HILLS PARKWAY SUITE 225
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48304
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Country | US
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Telephone | 248-452-6669
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Fax |
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Provider Business Mailing Address
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Address Line | 32406 FRANKLIN RD. UNIT 250302
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City | FRANKLIN
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State | MI
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Zip | 48025
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Country | US
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Telephone | 248-452-6669
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | BROOKE COLMAN
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Credential | PSY.D., L.P.
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Telephone | 248-452-6669
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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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