Organization
STEVEN J CERESNIE PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN J CERESNIE PHD (OWNER)
(734) 453-9290
Entity
Organization
Contact information
Practice address
199 N MAIN ST, PLYMOUTH, MI 48170-1272
(734) 453-9290
(734) 453-9293
Mailing address
199 N MAIN ST, PLYMOUTH, MI 48170-1272
(734) 453-9290
(734) 453-9293
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301002659
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
620H24558
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
09/09/2008
Last updated
10/27/2008
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