Organization Name: | PSYCHOLOGY ASSOCIATES OF THE KEWEENAW, P.C. |
NPI Number: | 1588790935 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT WILLIAM SHARKEY (PRESIDENT) |
Mailing Address: | 56730 Calumet Ave Ste F Calumet |
State: | MI US |
Postal Code: | 499132968 |
Phone Number: | 9063376839 |
Fax Number: | 9063370944 |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6301007915 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |