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General NPI Number Information
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NPI Number | 1609727882
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Entity Type | Organization
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Legal Business Name | MOMENTUM MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 41100 PLYMOUTH RD STE B1-162
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City | PLYMOUTH
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State | MI
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Zip | 48170-3799
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Country | US
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Telephone | 734-634-6449
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Fax |
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Provider Business Mailing Address
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Address Line | 41100 PLYMOUTH RD STE B1-162
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City | PLYMOUTH
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State | MI
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Zip | 48170-3799
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELANIE MOORE
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Credential | PA-C
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Telephone | 734-634-6449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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