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General NPI Number Information
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NPI Number | 1962752436
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Entity Type | Organization
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Legal Business Name | REGENTS OF THE UNIVERSITY OF MICHIGAN CENTER FOR THE CHILD AND FAMILY
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 530 CHURCH ST SUITE 1465
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City | ANN ARBOR
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State | MI
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Zip | 48109-1043
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Country | US
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Telephone | 734-764-9466
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Fax | 734-647-1051
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Provider Business Mailing Address
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Address Line | 530 CHURCH ST SUITE 1465
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City | ANN ARBOR
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State | MI
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Zip | 48109-1043
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Country | US
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Telephone | 734-764-9466
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Fax | 734-647-1051
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CYNTHIA EWELL FOSTER
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Credential | PH.D.
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Telephone | 734-764-9466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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