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General NPI Number Information
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NPI Number | 1558595488
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Entity Type | Individual
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Provider Name | ARLENE ARCHER PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 08/24/2009
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Provider Practice Location Address
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Address Line | 205 BROADWAY ST SUITE A
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City | NILES
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State | MI
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Zip | 49120-2778
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Country | US
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Telephone | 269-683-8972
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Fax | 269-683-0449
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Provider Business Mailing Address
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Address Line | 3848 MAPLE LN
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City | BERRIEN SPRINGS
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State | MI
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Zip | 49103-9642
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Country | US
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Telephone | 269-240-3085
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Fax | 269-683-0449
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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 | 6301014106
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License Number State | GA
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