MEDICARE: ANNE M. YURIK, PH.D, P.C.

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	251S00000X	Community/Behavioral Health Agency	6301007587	MI

General Provider Information

NPI Number	:	1649461047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANNE M. YURIK, PH.D, P.C.

Provider Business Mailing Address
First Line	:	563 BOLINGER ST
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2818
Country	:	US
Telephone Number	:	248-299-4315
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 DIVERSION ST STE 150
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2245
Country	:	US
Telephone Number	:	248-299-4315
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANNE MARIE YURIK
Credential	:	PH.D.
Telephone Number	:	248-299-4315

Provider Enumeration Date	:	08/09/2007
Last Update Date	:	08/09/2007

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