Organization
RIVERS EDGE PSYCHOLOGICAL SERVICES PC
Active
Other names
RIVERS EDGE PSYCHOLOGICAL SERVICES PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEFANIE GILL SCALCUCCI PH.D. (PSYCHOLOGIST)
(734) 642-8803
Entity
Organization
Contact information
Practice address
12240 OELKE RD, MAYBEE, MI 48159-9779
(734) 642-8803
Mailing address
717 N MACOMB ST, MONROE, MI 48162-2929
(734) 258-3518
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VS0190006
—
MI
Enumeration date
02/12/2021
Last updated
12/08/2021
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