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General NPI Number Information
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NPI Number | 1659738664
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Entity Type | Organization
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Legal Business Name | DML PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 39532 KARTAR LN
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City | NOVI
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State | MI
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Zip | 48375-4520
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Country | US
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Telephone | 734-743-7434
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Fax |
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Provider Business Mailing Address
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Address Line | 39532 KARTAR LN
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City | NOVI
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State | MI
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Zip | 48375-4520
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Country | US
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Telephone | 734-743-7434
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELE LENO
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Credential | PHD
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Telephone | 734-743-7434
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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 | 6301013798
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License Number State | MI
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