Doctor Name: | ANNE KRISTINE HERRICK |
NPI Number: | 1033466974 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 6801080153 |
Business Practice Address: | 719 N Valley Chase Rd Bloomfield Hills, MI - 483043169 |
Business Phone Number: | 2487239017 |
Business Fax Number: | |
Mailing Address: | 719 N Valley Chase Rd, BLOOMFIELD HILLS |
State: | MI |
Postal Code: | 483043169 |
Phone Number: | 2487239017 |
Fax Number: | |
NPI Enumeration Date: | 08/09/2012 |
NPI Last Update Date: | 08/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6801080153 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |