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Organization
MICHIGAN BEHAVIORAL MEDICINE
Active
Organization
MICHIGAN BEHAVIORAL MEDICINE
Active
Parent organization
MICHIGAN BEHAVIORAL MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHIGAN BEHAVIORAL MEDICINE
Authorized official
MS. RENE JOSEPH (ADMINISTRATOR)
(248) 703-1897
Entity
Organization
Contact information
Practice address
2525 CROOKS RD STE 100, TROY, MI 48084-4733
(248) 731-7305
(248) 731-7288
Mailing address
2525 CROOKS RD STE 100, TROY, MI 48084-4733
(248) 731-7305
(248) 731-7288
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
MI
103T00000X
Psychologist
—
MI
104100000X
Social Worker
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922195999
TYPE 2 NPI
MI
Enumeration date
03/10/2011
Last updated
06/28/2021
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