| Doctor Name: | DR. PHYLLIS M. FLORIAN |
| NPI Number: | 1023238623 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D |
| License Number: | |
| Business Practice Address: | 6100 Newport Rd Suite 222 Portage, MI - 490029235 |
| Business Phone Number: | 2693241248 |
| Business Fax Number: | 2693241248 |
| Mailing Address: | 6100 Newport Rd, Ste 222 PORTAGE |
| State: | MI |
| Postal Code: | 490029235 |
| Phone Number: | 2693527922 |
| Fax Number: | 2693887678 |
| NPI Enumeration Date: | 04/26/2007 |
| NPI Last Update Date: | 03/30/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |