MEDICARE: MS. ANNE MARIE DOHRENWEND 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	6301010100	MI
2	103TC1900X	Counseling Psychologist	6301010100	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	056350	OTHER		VQLUE OPTIONS
2	0985309	OTHER	MI	HEALTH PLUS
3	253151	OTHER	MI	HEALTH ADVANTAGE NETWORK
4	253151	OTHER	MI	MCLAREN HEALTH PLAN
5	1962541318	OTHER		MCLAREN GROUP NPI #
6	680B512650	OTHER	MI	BCBSM-BCN-FEP

General Provider Information

NPI Number	:	1619959400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNE MARIE DOHRENWEND PHD

Provider Business Mailing Address
First Line	:	904 SPRING ST
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-3243
Country	:	US
Telephone Number	:	734-657-9034
Fax Number	:	810-342-1590

Provider Business Practice Location Address
First Line	:	202 E WASHINGTON ST STE 606
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48104-2012
Country	:	US
Telephone Number	:	734-657-9033
Fax Number	:

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	07/21/2022

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