Organization
NORTHBROOK PSYCHOLOGICAL CLINIC PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA D KRESTA PSYD (OWNER)
(248) 344-7420
Entity
Organization
Contact information
Practice address
43450 W 10 MILE RD, NOVI, MI 48375-3172
(248) 344-7420
(248) 344-7423
Mailing address
43450 W 10 MILE RD, NOVI, MI 48375-3172
(248) 344-7420
(248) 344-7423
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8008927170
BCBS SOCIAL WORKER
MI
Enumeration date
01/13/2006
Last updated
10/12/2007
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