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General NPI Number Information
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NPI Number | 1821525569
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Entity Type | Organization
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Legal Business Name | PSYCHOANALYTICAL & RESEARCH FOUNDATION
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Dates
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Enumeration Date | 05/12/2017
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 2885 SANFORD AVE SW # 23719
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City | GRANDVILLE
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State | MI
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Zip | 49418-1342
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Country | US
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Telephone | 425-606-5304
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Fax |
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Provider Business Mailing Address
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Address Line | 2885 SANFORD AVE SW # 23719
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City | GRANDVILLE
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State | MI
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Zip | 49418-1342
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. ANNE EDWARDS
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Credential | PHD
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Telephone | 425-606-5304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number |
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License Number State |
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