Organization
PEACEFUL BANYAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE MARIE CALDWELL MS LLP (SOLE MEMBER)
(248) 444-5479
Entity
Organization
Contact information
Practice address
409 PLYMOUTH RD STE 270, PLYMOUTH, MI 48170-1842
(248) 444-5479
Mailing address
409 PLYMOUTH RD STE 270, PLYMOUTH, MI 48170-1842
(248) 444-5479
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
05/21/2020
Last updated
05/21/2020
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