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General NPI Number Information
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NPI Number | 1881881332
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Entity Type | Individual
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Provider Name | ELIZABETH ANN MUENK M.A., L.L.P.
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Gender | Female
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 23700 VAN DYKE AVE
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City | WARREN
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State | MI
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Zip | 48089-1600
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Country | US
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Telephone | 586-758-6670
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Fax |
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Provider Business Mailing Address
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Address Line | 516 MAGNOLIA AVE
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City | ROYAL OAK
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State | MI
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Zip | 48073-4016
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Country | US
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Telephone | 248-850-6972
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6301013648
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License Number State | MI
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