Organization
OLIPHANT CONSULTING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELYN OLIPHANT PH.D. (VICE PRESIDENT)
(248) 924-2133
Entity
Organization
Contact information
Practice address
725 S ADAMS RD, SUITE 241, BIRMINGHAM, MI 48009-6902
(248) 924-2133
(248) 924-2599
Mailing address
143 CADYCENTRE, 206, NORTHVILLE, MI 48167-1119
(248) 924-2133
(248) 924-2599
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301005964
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F30377
BLUE CROSS BLUE SHIELD
MI
01
—
0P60180
MEDICARE PTAN
MI
01
—
3045752
CIGNA
MI
Enumeration date
10/03/2013
Last updated
10/03/2013
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