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General NPI Number Information
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NPI Number | 1710189147
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGY ASSOCIATES OF MICHIGAN PC
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 03/19/2013
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Provider Practice Location Address
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Address Line | 1708 ROSELAND AVE
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City | ROYAL OAK
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State | MI
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Zip | 48073-3978
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Country | US
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Telephone | 248-514-5371
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Fax |
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Provider Business Mailing Address
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Address Line | 1708 ROSELAND AVE
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City | ROYAL OAK
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State | MI
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Zip | 48073-3978
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Country | US
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Telephone | 248-514-5371
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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. AMY E. MONICATTI
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Credential | PSY.D.
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Telephone | 248-514-5371
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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 | 6301011291
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License Number State | MI
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