Organization Name: | GREGORY G NORTH PHD PC |
NPI Number: | 1609061464 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GREGORY G NORTH (OWNER) |
Mailing Address: | 11293 N M 37 Suite A Buckley |
State: | MI US |
Postal Code: | 496209593 |
Phone Number: | 2319334268 |
Fax Number: | 2312694461 |
NPI Enumeration Date: | 09/13/2007 |
NPI Last Update Date: | 09/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6301005865 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |