Organization
SENIOR PSYCHIATRIC SERVICES OF MI, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA KOELZER PA-C (MANAGING PARTNER)
(734) 634-9965
Entity
Organization
Contact information
Practice address
38807 ANN ARBOR RD STE 7, LIVONIA, MI 48150-3896
(734) 953-6734
(734) 953-6738
Mailing address
38807 ANN ARBOR RD STE 7, LIVONIA, MI 48150-3896
(734) 953-6734
(734) 953-6738
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/14/2006
Last updated
01/24/2019
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