Individual
DR. AMI SHETH ANTONUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
31600 TELEGRAPH RD STE 250, BINGHAM FARMS, MI 48025-4317
(248) 690-6993
Mailing address
31600 TELEGRAPH RD STE 250, BINGHAM FARMS, MI 48025-4317
(248) 690-6993
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301012812
MI
103TA0700X
Adult Development & Aging Psychologist
6301012812
MI
103TC0700X
Clinical Psychologist
6301012812
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301012812
MI
Other
Enumeration date
05/04/2007
Last updated
11/28/2017
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