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NPI Code Detail

MEDICARE: ALICIA MARIE WEISENSEL MS, LLP

MEDICARE:   ALICIA MARIE WEISENSEL  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
1103TC0700XClinical Psychologist6301015544MI

General Provider Information

NPI Number : 1962918615
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA MARIE WEISENSEL MS, LLP
Provider Business Mailing Address
First Line : 9258 ABBEY LN
Second Line :
City : YPSILANTI
State : MI
Zip : 48198-9414
Country : US
Telephone Number : 781-799-0968
Fax Number :
Provider Business Practice Location Address
First Line : 27780 NOVI RD STE 107
Second Line :
City : NOVI
State : MI
Zip : 48377-3427
Country : US
Telephone Number : 781-799-0968
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2017
Last Update Date : 12/18/2017

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Directions to “ ALICIA MARIE WEISENSEL MS, LLP” Practice Location

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