Individual
DR. JOHN ANTHONY DOOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2799 W GRAND BLVD, PAIN CLINIC I-3, DETROIT, MI 48202-2608
(313) 916-7949
(313) 916-8023
Mailing address
2799 W GRAND BLVD, PAIN CLINIC I-3, DETROIT, MI 48202-2608
(313) 916-7949
(313) 916-8023
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301003951
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038522
VALUE OPTIONS PROVIDER ID
MI
01
—
68 0E0 4569
BLUE CROSS PROVIDER IDN
MI
Enumeration date
12/27/2005
Last updated
03/26/2021
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