Organization
GERIATRIC PSYCHIATRIC SERVICES PLLC
Active
Parent organization
GERIATRIC PSYCHIATRIC SERVICES PLLC
Other names
Psychologist Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
GERIATRIC PSYCHIATRIC SERVICES PLLC
Authorized official
ROBERT CLEMENTE (MANAGER)
(248) 619-9771
Entity
Organization
Contact information
Practice address
2024 ADDERBURY LN, MADISON, WI 53711-4002
(734) 883-3021
Mailing address
30781 STEPHENSON HWY, MADISON HTS, MI 48071-1618
(248) 583-8922
(248) 583-8969
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
10/20/2009
Last updated
10/20/2009
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