Individual
DR. TRISHA LYN STOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY. D.
Contact information
Practice address
17940 FARMINGTON RD STE 225, LIVONIA, MI 48152-3195
(800) 693-1916
(248) 605-3525
Mailing address
22466 CYPRUS DR, NORTHVILLE, MI 48167-8500
(248) 568-7636
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
Primary
6301012416
MI
103TC0700X
Clinical Psychologist
6301012416
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
381576680
TAX ID
MI
Enumeration date
10/23/2006
Last updated
10/07/2018
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