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General NPI Number Information
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NPI Number | 1881001428
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Entity Type | Organization
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Legal Business Name | A R RICKFELDER PHD PC
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 07/15/2014
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Provider Practice Location Address
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Address Line | 640 GRISWOLD ST
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City | NORTHVILLE
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State | MI
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Zip | 48167-1690
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Country | US
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Telephone | 248-348-1100
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Fax | 248-348-3410
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Provider Business Mailing Address
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Address Line | 640 GRISWOLD ST
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City | NORTHVILLE
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State | MI
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Zip | 48167-1690
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Country | US
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Telephone | 248-348-1100
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Fax | 248-348-3410
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Authorized Official
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Title or Position | PHD / OWNER
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Name | DR. ALAN R RICKELDER
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Credential | PHD
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Telephone | 248-348-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301001110
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License Number State | MI
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