Organization
PANOPTIC PSYCHOLOGY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WILSON L.L.P. (OWNER)
(313) 402-0898
Entity
Organization
Contact information
Practice address
25415 SOUTHFIELD RD, SOUTHFIELD, MI 48075-1907
(313) 402-0898
Mailing address
17608 FIELDING ST, DETROIT, MI 48219-5219
(313) 402-0898
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
03/21/2026
Last updated
03/21/2026
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