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General NPI Number Information
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NPI Number | 1730678350
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Entity Type | Organization
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Legal Business Name | KNAPP PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 1100 CORPORATE OFFICE DR STE 300
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City | MILFORD
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State | MI
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Zip | 48381-5002
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Country | US
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Telephone | 734-564-7169
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 CORPORATE OFFICE DR STE 300
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City | MILFORD
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State | MI
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Zip | 48381-5002
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Country | US
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Telephone | 734-564-7169
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Fax | 734-780-3005
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | MELISSA J KNAPP
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Credential | LLP
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Telephone | 734-564-7169
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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 | 6301015282
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License Number State | MI
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