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Organization
OLD TOWN PSYCHOLOGICAL SERVICES-GAYLORD
Active
Organization
OLD TOWN PSYCHOLOGICAL SERVICES-GAYLORD
Active
Parent organization
OLD TOWN PSYCHOLOGICAL SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
OLD TOWN PSYCHOLOGICAL SERVICES
Authorized official
DR. MICHAEL P HAYES PH.D. (CEO)
(989) 448-8344
Entity
Organization
Contact information
Practice address
128 N COURT AVE, GAYLORD, MI 49735-1408
(989) 448-8344
Mailing address
512 S UNION ST, TRAVERSE CITY, MI 49684-3247
(231) 941-6550
(231) 941-8981
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
12/12/2011
Last updated
12/12/2011
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