Organization
PATHWAY PSYCHOLOGICAL SERVICES PLLC
Active
Other names
Dr. Brian D. Wummel
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN D WUMMEL PH.D., LPC (OWNER AND COUNSELOR)
(810) 333-1386
Entity
Organization
Contact information
Practice address
22750 WOODWARD AVE STE 211, FERNDALE, MI 48220-1753
(810) 333-1386
Mailing address
1683 RIVERSIDE DR APT 2, ROCHESTER HILLS, MI 48309-2708
(810) 333-1386
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811291818
NPI
MI
Enumeration date
06/25/2019
Last updated
06/25/2019
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