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Individual

DR. JEFFREY WAYNE HYDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D

Contact information

Practice address
42690 WOODWARD AVE, SUITE 300, BLOOMFIELD HILLS, MI 48304-5062
(248) 454-0129
Mailing address
42690 WOODWARD AVE, SUITE 300, BLOOMFIELD HILLS, MI 48304-5062
(248) 454-0129

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301005918
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
62-0-F3-4907
BCBS OF MI
MI
Enumeration date
02/05/2008
Last updated
02/05/2008
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