Organization
PROFESSIONAL PSYCHOLOGICAL & REHABILITATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HILTON T THOMAS PH.D. (EXECUTIVE DIRECTOR)
(517) 321-5900
Entity
Organization
Contact information
Practice address
3815 W ST JOSEPH HWY, SUITE A101, LANSING, MI 48917
(517) 321-5900
(517) 321-5945
Mailing address
3815 W ST JOSEPH HWY, SUITE A101, LANSING, MI 48917
(517) 321-5900
(517) 321-5945
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301003971
MI
1041C0700X
Clinical Social Worker
6801063438
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OC34604
—
MI
Enumeration date
04/04/2007
Last updated
10/17/2017
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