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General NPI Number Information
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NPI Number | 1932241866
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 2095 NILES RD
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-2473
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Country | US
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Telephone | 269-985-4751
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Fax | 269-983-0803
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Provider Business Mailing Address
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Address Line | 2095 NILES RD
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-2473
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Country | US
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Telephone | 269-985-4751
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Fax | 269-983-0803
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Authorized Official
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Title or Position | OWNER
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Name | MR. FREDERICK TOBIN SULIER
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Credential | ED.D
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Telephone | 269-983-4751
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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 | 6301012953
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301007140
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301003207
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301009442
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License Number State | MI
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