Organization
INDIVIDUALLYTICS, INC.
Active
Other names
IndividuALLytics Connected Care
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS NASH (PRESIDENT)
(248) 432-0175
Entity
Organization
Contact information
Practice address
330 E LIBERTY ST, ANN ARBOR, MI 48104-2274
(248) 505-3175
Mailing address
3765 SANCROFT AVE, WEST BLOOMFIELD, MI 48324-2658
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
Other
Enumeration date
08/12/2019
Last updated
07/29/2020
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