Individual
ALICE MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
332 E WASHINGTON ST, SUTE B, ANN ARBOR, MI 48104-2062
(734) 680-5869
Mailing address
332 E WASHINGTON ST, SUTE B, ANN ARBOR, MI 48104-2062
(734) 680-5869
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301014762
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OH10522
BCBS OF MICHIGAN
MI
Enumeration date
12/07/2006
Last updated
11/11/2015
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