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General NPI Number Information
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NPI Number | 1558594283
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Entity Type | Organization
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Legal Business Name | GEORGE PSYCHOLOGICAL SERVICES PC
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Dates
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Enumeration Date | 08/28/2009
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Last Update Date | 08/28/2009
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Provider Practice Location Address
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Address Line | 2314 MONROE
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City | DEARBORN
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State | MI
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Zip | 48124-3045
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Country | US
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Telephone | 313-562-6709
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Fax | 313-562-0880
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Provider Business Mailing Address
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Address Line | 2314 MONROE
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City | DEARBORN
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State | MI
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Zip | 48124-3045
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Country | US
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Telephone | 313-562-6709
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Fax | 313-562-0880
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN ARNOLD GEORGE
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Credential | PH.D. L.P.
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Telephone | 313-562-6709
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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 | 1367
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License Number State | MI
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