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NPI Code Detail

MEDICARE: KYRIAKOULA PLIAKAS MS,LLP

MEDICARE: KYRIAKOULA PLIAKAS MS,LLP
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
1103K00000XBehavior Analyst6301007489MI
2103T00000XPsychologist6301007489MI

General Provider Information

NPI Number : 1336567122
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYRIAKOULA PLIAKAS MS,LLP
Provider Business Mailing Address
First Line : 3200 E EISENHOWER PKWY
Second Line :
City : ANN ARBOR
State : MI
Zip : 48108-3231
Country : US
Telephone Number : 734-677-0070
Fax Number : 734-677-0890
Provider Business Practice Location Address
First Line : 3200 E EISENHOWER PKWY
Second Line :
City : ANN ARBOR
State : MI
Zip : 48108-3231
Country : US
Telephone Number : 734-677-0070
Fax Number : 734-677-0890
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2014
Last Update Date : 03/31/2014

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