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General NPI Number Information
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NPI Number | 1699076950
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Entity Type | Individual
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Provider Name | CAROLE E. WEST PHD
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Gender | Female
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 02/07/2019
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Provider Practice Location Address
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Address Line | 603 N GAINSBOROUGH AVE
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City | ROYAL OAK
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State | MI
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Zip | 48067-1938
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Country | US
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Telephone | 248-607-3455
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Fax | 248-592-7053
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Provider Business Mailing Address
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Address Line | 603 N GAINSBOROUGH AVE
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City | ROYAL OAK
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State | MI
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Zip | 48067-1938
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Country | US
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Telephone | 248-607-3455
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Fax | 248-592-7053
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301014339
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License Number State | MI
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