Organization
SAGE TREE PSYCHOLOGY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAWN BANE GVENTER PSY.D (PSYCHOLOGIST)
(248) 303-1382
Entity
Organization
Contact information
Practice address
925 N LAPEER RD, STE 151, OXFORD, MI 48371-6742
(248) 303-1382
Mailing address
1179 BELLWOOD CT, OXFORD, MI 48371-6732
(248) 303-1382
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301013477
MI
Other
Enumeration date
01/26/2017
Last updated
01/28/2017
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