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Organization

INTERFACE I PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA ARMSTRONG PH.D. (OWNER)
(248) 674-2659
Entity
Organization

Contact information

Practice address
4170 PONTIAC LAKE RD, WATERFORD, MI 48328-1282
(248) 674-2659
(248) 674-2659
Mailing address
4170 PONTIAC LAKE RD, WATERFORD, MI 48328-1282
(248) 674-2659
(248) 674-2659

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301007437
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
680F330170
BCBSM
MI
Enumeration date
03/22/2007
Last updated
05/14/2008
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