Organization
CENTRAL MICHIGAN UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL SIAS (CREDENTIALING)
(989) 774-2597
Entity
Organization
Contact information
Practice address
1101 HEALTH PROFESSIONS BLDG, STE 2105, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Mailing address
1101 HEALTH PROFESSIONS BLDG, STE 2105, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
103TS0200X
School Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193400000X
TAXONOMY
—
Enumeration date
11/19/2015
Last updated
11/19/2015
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