MEDICARE: AKARI ASSESSMENT & PSYCHOTHERAPY

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

General Provider Information

NPI Number	:	1508683434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKARI ASSESSMENT & PSYCHOTHERAPY

Provider Business Mailing Address
First Line	:	1091 GREEN RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48105-2801
Country	:	US
Telephone Number	:	734-386-0369
Fax Number	:

Provider Business Practice Location Address
First Line	:	1091 GREEN RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48105-2801
Country	:	US
Telephone Number	:	734-386-0369
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	AKI KAWAMOTO
Credential	:
Telephone Number	:	734-386-0369

Provider Enumeration Date	:	09/23/2024
Last Update Date	:	09/23/2024

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