Organization
GREAT MINDS OF MICHIGAN PLLC
Active
Organization
GREAT MINDS OF MICHIGAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANET S REED PHD (MEMBER, DIRECTOR)
(586) 913-1038
Entity
Organization
Contact information
Practice address
200 DIVERSION ST, SUITE 150, ROCHESTER HILLS, MI 48307-2267
(586) 913-1038
(586) 773-3355
Mailing address
23210 GREATER MACK AVE, #216, SAINT CLAIR SHORES, MI 48080-3422
(586) 913-1038
(586) 773-3355
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301012828
MI
103TC0700X
Clinical Psychologist
6301012828
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301012828
MI
103TM1800X
Intellectual & Developmental Disabilities Psychologist
6301012828
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JR012828
CHAMPUS-CHAMPUS
MI
05
—
PHD888810
—
MI
Enumeration date
02/23/2011
Last updated
02/23/2011
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