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General NPI Number Information
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NPI Number | 1518013986
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Entity Type | Individual
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Provider Name | THOMAS S ROSENBAUM PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 4343 CONCOURSE DR STE 250
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City | ANN ARBOR
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State | MI
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Zip | 48108-8672
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Country | US
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Telephone | 734-677-0200
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Fax | 734-677-3310
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Provider Business Mailing Address
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Address Line | 4343 CONCOURSE DR STE 250
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City | ANN ARBOR
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State | MI
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Zip | 48108-8672
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Country | US
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Telephone | 734-677-0200
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Fax | 734-677-3310
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301001432
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License Number State | MI
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