| Alliance Psychological Services | |
|
1135 W University Dr Ste 445 Rochester MI 48307-1871 | |
| (224) 595-8416 | |
| Not Available |
| Full Name | Alliance Psychological Services |
|---|---|
| Speciality | Psychologist |
| Location | 1135 W University Dr Ste 445, Rochester, Michigan |
| Authorized Official Name and Position | Antonino Agosta (OWNER) |
| Authorized Official Contact | 2486788606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Psychological Services 2175 London Bridge Dr Rochester Hills MI 48307-4234 Ph: (248) 678-8606 | Alliance Psychological Services 1135 W University Dr Ste 445 Rochester MI 48307-1871 Ph: (224) 595-8416 |
| NPI Number | 1639558620 |
|---|---|
| Provider Enumeration Date | 05/22/2015 |
| Last Update Date | 03/08/2022 |
| Certification Date | 03/02/2022 |
| Medicare PECOS PAC ID | 5395641369 |
|---|---|
| Medicare Enrollment ID | O20150807013516 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639558620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301015487 (Michigan) | Primary |
| Provider Name | Antonino Agosta |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396913497 PECOS PAC ID: 0345482030 Enrollment ID: I20130808000549 |
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