MEDICARE: DR. AMBER M SEPSEY PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6301019118	MI

General Provider Information

NPI Number	:	1275014433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMBER M SEPSEY PHD

Provider Business Mailing Address
First Line	:	135 N OLD WOODWARD AVE STE 200
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-3341
Country	:	US
Telephone Number	:	248-385-3330
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 N OLD WOODWARD AVE STE 200
Second Line	:
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-3341
Country	:	US
Telephone Number	:	248-385-3330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	11/11/2022

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