Doctor Name: | DR. MICHAEL PAUL WOLFF |
NPI Number: | 1528147360 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYD |
License Number: | 6301012443 |
Business Practice Address: | 3351 Eagle Run Dr Ne Suite C Grand Rapids, MI - 495257053 |
Business Phone Number: | 6163658920 |
Business Fax Number: | 6163658971 |
Mailing Address: | 7138 Lake Vista Dr Sw, Apartment #2b BYRON CENTER |
State: | MI |
Postal Code: | 493158547 |
Phone Number: | 6165830803 |
Fax Number: | 6163658971 |
NPI Enumeration Date: | 11/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 6301012443 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |