Organization
UNIVERSITY PEDIATRICIANS AUTISM CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK HARRISON (CAO)
(313) 745-6911
Entity
Organization
Contact information
Practice address
21600 NOVI RD STE 800, NOVI, MI 48375-5608
(248) 305-6172
(248) 305-6202
Mailing address
21600 NOVI RD STE 800, NOVI, MI 48375-5608
(248) 305-6172
(248) 305-6202
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TE1100X
Exercise & Sports Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
103TS0200X
School Psychologist
—
—
Other
Enumeration date
05/11/2012
Last updated
09/29/2023
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