Doctor Name: | DR. RUTH L. ROSENTHAL |
NPI Number: | 1023061199 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 6301002779 |
Business Practice Address: | 4572 S Hagadorn Rd Suite 2e East Lansing, MI - 488235385 |
Business Phone Number: | 5173334455 |
Business Fax Number: | 5173339680 |
Mailing Address: | 4572 S Hagadorn Rd, Suite 2e EAST LANSING |
State: | MI |
Postal Code: | 488235385 |
Phone Number: | 5173334455 |
Fax Number: | 5173339680 |
NPI Enumeration Date: | 05/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6301002779 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |