Individual
PAMELA D KRESTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
43450 W 10 MILE RD, NOVI, MI 48375-3172
(248) 344-7420
(248) 344-7423
Mailing address
43450 W 10 MILE RD, NOVI, MI 48375-3172
(248) 344-7420
(248) 344-7423
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301009266
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300040030
NPC TAX ID
MI
01
—
416889
VO
MI
01
—
680F321030
BC GROUP PIN
MI
01
—
680F333010
PERS BC PIN
MI
Enumeration date
01/04/2007
Last updated
08/21/2008
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