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General NPI Number Information
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NPI Number | 1508682923
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Entity Type | Organization
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Legal Business Name | EASTON PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 3260 COOLIDGE HWY STE 2
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City | BERKLEY
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State | MI
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Zip | 48072-1694
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Country | US
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Telephone | 313-497-2725
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Fax |
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Provider Business Mailing Address
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Address Line | 651 BOWERS ST
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City | CLAWSON
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State | MI
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Zip | 48017-2167
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Country | US
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Telephone | 248-231-1727
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Fax |
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Authorized Official
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Title or Position | OWNER, CLINICIAN
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Name | HILLARY EASTON
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Credential | MS, LLP
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Telephone | 248-231-1727
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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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