Organization
THE SLYCHOLOGY DEPARTMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN LEE BLACKSTOCK PSY.D (OWNER)
(248) 763-9194
Entity
Organization
Contact information
Practice address
32770 GRAND RIVER AVE STE 206B, FARMINGTON HILLS, MI 48336-3159
(248) 763-9194
Mailing address
9237 BECKER AVE, ALLEN PARK, MI 48101-1563
(248) 763-9194
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/19/2021
Last updated
09/05/2021
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