Individual
PETER IANNI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
32905 TWELVE MILE RD, STE 130, FARMINGTON HILLS, MI 48334-3343
(248) 553-4888
(248) 553-3601
Mailing address
32905 TWELVE MILE RD, STE 130, FARMINGTON HILLS, MI 48334-3343
(248) 553-4888
(248) 553-3601
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301005479
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132988200
DEPARTMENT OF LABOR
—
01
—
P00088254
RAILROAD MEDICARE
—
Enumeration date
12/28/2005
Last updated
10/23/2011
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