Organization
THERA SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS S ROSENBAUM PHD (LICENSED PSYCHOLOGIST)
(734) 677-0200
Entity
Organization
Contact information
Practice address
4343 CONCOURSE DR STE 250, ANN ARBOR, MI 48108-8672
(734) 677-0200
(734) 677-3310
Mailing address
4343 CONCOURSE DR STE 250, ANN ARBOR, MI 48108-8672
(734) 677-0200
(734) 677-3310
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301001432
MI
225100000X
Physical Therapist
5501012103
MI
225X00000X
Occupational Therapist
5201000891
MI
Other
Enumeration date
09/11/2007
Last updated
12/13/2022
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