Individual
DR. JONATHAN DAVID FALK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
999 HAYNES ST STE 200, BIRMINGHAM, MI 48009-6775
(248) 547-6982
(248) 547-6982
Mailing address
999 HAYNES ST STE 200, BIRMINGHAM, MI 48009-6775
(248) 547-6982
(248) 547-6982
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301005819
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EIN 20-0246033
STATE OF MICHIGAN
—
Enumeration date
03/27/2009
Last updated
03/27/2009
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