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Organization

GRAND TRAVERSE ASSESSMENT AND THERAPY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT FABIANO PHD (CO-MANAGER)
(517) 243-7027
Entity
Organization

Contact information

Practice address
5123 N ROYAL DR, TRAVERSE CITY, MI 49684-9201
(517) 887-9801
Mailing address
5123 N ROYAL DR, TRAVERSE CITY, MI 49684-9201

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
09/10/2018
Last updated
01/28/2019
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