Organization
LIFESPAN NEUROPSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMI ANTONUCCI PHD (OWNER)
(248) 690-6993
Entity
Organization
Contact information
Practice address
31600 TELEGRAPH RD STE 250, BINGHAM FARMS, MI 48025-4317
(248) 690-6993
Mailing address
31600 TELEGRAPH RD STE 250, BINGHAM FARMS, MI 48025-4317
(248) 690-6993
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
MI
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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