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General NPI Number Information
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NPI Number | 1710388913
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Entity Type | Organization
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Legal Business Name | THRIVING MINDS BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 09/08/2014
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 8163 GRAND RIVER RD STE 100
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City | BRIGHTON
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State | MI
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Zip | 48114-9482
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Country | US
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Telephone | 810-225-3417
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Fax |
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Provider Business Mailing Address
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Address Line | 8163 GRAND RIVER RD STE 100
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City | BRIGHTON
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State | MI
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Zip | 48114-9482
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Country | US
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Telephone | 810-225-3417
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AIMEE KOTRBA
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Credential | PHD
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Telephone | 810-225-3417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 1033328166
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License Number State | MI
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