Individual
JOHN H TRASK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
650 E BIG BEAVER RD, SUITE A, TROY, MI 48083-1432
(248) 689-4600
(248) 519-1201
Mailing address
200 E BIG BEAVER RD, TROY, MI 48083-1208
(248) 689-4600
(248) 519-1201
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007751
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164693362
NPPES
—
01
—
68-0-F3-2859-0
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
03/01/2006
Last updated
01/13/2021
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