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General NPI Number Information
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NPI Number | 1861258444
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Entity Type | Organization
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Legal Business Name | HODGES-PIETRYKA PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 18625 INNSBROOK DR APT 2
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City | NORTHVILLE
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State | MI
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Zip | 48168-2428
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Country | US
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Telephone | 248-553-0814
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Fax |
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Provider Business Mailing Address
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Address Line | 18625 INNSBROOK DR APT 2
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City | NORTHVILLE
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State | MI
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Zip | 48168-2428
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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 | PSYCHOLOGIST
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Name | DR. MICHELLE HODGES-PIETRYKA
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Credential | LP, PSYD
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Telephone | 248-533-0814
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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 |
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License Number State |
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