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General NPI Number Information
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NPI Number | 1922437664
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Entity Type | Individual
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Provider Name | ELIZABETH WEBSTER LLP
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Gender | Female
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 17000 EXECUTIVE PLAZA DR
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City | DEARBORN
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State | MI
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Zip | 48126-2793
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Country | US
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Telephone | 248-429-9145
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Fax |
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Provider Business Mailing Address
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Address Line | 463 MAPLEWOOD ST
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City | NORTHVILLE
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State | MI
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Zip | 48167-1151
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Country | US
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Telephone | 313-303-4691
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301015143
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License Number State | MI
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