Individual
DR. RICHARD DOMBROWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
836 CENTENNIAL WAY, SUITE 160, LANSING, MI 48917-8238
(517) 703-0110
(517) 703-0113
Mailing address
836 CENTENNIAL WAY, SUITE 160, LANSING, MI 48917-8238
(517) 703-0110
(517) 703-0113
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301006528
MI
103TC0700X
Clinical Psychologist
Primary
6301006528
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5247231
AETNA
—
01
—
61-45416
PHP OF MID MI
—
01
—
680B345140
BLUE CROSS & BLUE SHIELD
MI
Enumeration date
11/17/2006
Last updated
09/26/2014
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