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General NPI Number Information
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NPI Number | 1649461047
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Entity Type | Organization
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Legal Business Name | ANNE M. YURIK, PH.D, P.C.
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 08/09/2007
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Provider Practice Location Address
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Address Line | 200 DIVERSION ST STE 150
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2245
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Country | US
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Telephone | 248-299-4315
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Fax |
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Provider Business Mailing Address
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Address Line | 563 BOLINGER ST
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2818
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Country | US
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Telephone | 248-299-4315
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANNE MARIE YURIK
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Credential | PH.D.
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Telephone | 248-299-4315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6301007587
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License Number State | MI
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