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General NPI Number Information
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NPI Number | 1528254729
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Entity Type | Organization
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Legal Business Name | HUFFMAN PSYCHOLOGY, PLLC
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 4572 S HAGADORN RD SUITE 2G
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City | EAST LANSING
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State | MI
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Zip | 48823-5385
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Country | US
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Telephone | 517-337-9554
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Fax | 517-337-9545
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Provider Business Mailing Address
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Address Line | 4572 S HAGADORN RD SUITE 2G
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City | EAST LANSING
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State | MI
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Zip | 48823-5385
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Country | US
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Telephone | 517-337-9554
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Fax | 517-337-9545
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Authorized Official
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Title or Position | CONSULTANT
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Name | TRACY FREEZE
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Credential |
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Telephone | 219-926-8320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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