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Individual

DR. SHERVIN TEHRANI-RAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD, MPH

Contact information

Practice address
415 MAIN ST STE A, SAINT JOSEPH, MI 49085-3100
(269) 408-1688
Mailing address
415 MAIN ST STE A, SAINT JOSEPH, MI 49085-3100
(269) 408-1688

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
33059
CA
103G00000X
Clinical Neuropsychologist
6301017839
MI
103T00000X
Psychologist
33059
CA
103T00000X
Psychologist
6301017839
MI
103TC0700X
Clinical Psychologist
33059
CA
103TC0700X
Clinical Psychologist
Primary
6301017839
MI

Other

Enumeration date
08/27/2012
Last updated
10/09/2022
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