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Organization

JUDITH ROES HAMMERLE, PH.D., LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUDITH ROES HAMMERLE PH.D. (PSYCHOLOGIST)
(517) 260-1762
Entity
Organization

Contact information

Practice address
1183 GLENDALE AVE, ADRIAN, MI 49221-1306
(517) 260-1762
(517) 265-2853
Mailing address
1183 GLENDALE AVE, ADRIAN, MI 49221-1306
(517) 260-1762
(517) 265-2853

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301002085
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03951
PARAMOUNT HEALTH CARE
MI
01
D64517
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
Enumeration date
08/06/2009
Last updated
04/21/2014
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