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Individual

DR. JACK NOVICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D

Contact information

Practice address
617 STRATFORD DR, ANN ARBOR, MI 48104-2745
(734) 665-6745
(734) 665-2875
Mailing address
617 STRATFORD DR, ANN ARBOR, MI 48104-2745
(734) 665-6745
(734) 665-2875

Taxonomy

Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
002202
MI
103TA0700X
Adult Development & Aging Psychologist
002202
MI
103TB0200X
Cognitive & Behavioral Psychologist
002202
MI
103TC0700X
Clinical Psychologist
Primary
002202
MI
103TC1900X
Counseling Psychologist
002202
MI
103TC2200X
Clinical Child & Adolescent Psychologist
002202
MI
103TF0000X
Family Psychologist
002202
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0HI45566
BLUE CROSS
MI
Enumeration date
03/14/2008
Last updated
03/14/2008
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