| Crossroads Group, LLC | |
|
667 Kuehnle St Ann Arbor MI 48103-2608 | |
| (734) 660-4828 | |
| (734) 994-9722 |
| Full Name | Crossroads Group, LLC |
|---|---|
| Speciality | Psychologist |
| Location | 667 Kuehnle St, Ann Arbor, Michigan |
| Authorized Official Name and Position | Dorella Louise Bond (MEMBER/OWNER) |
| Authorized Official Contact | 7346604828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Group, LLC 667 Kuehnle St Ann Arbor MI 48103-2608 Ph: (734) 660-4828 | Crossroads Group, LLC 667 Kuehnle St Ann Arbor MI 48103-2608 Ph: (734) 660-4828 |
| NPI Number | 1023116480 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 07/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023116480 | NPI | - | NPPES |
| 060001850CT01 | Other | CT | BC/BS OF CT |
| 1780613885 | Other | MI | INDIVIDUAL NPI |
| 68-0-F3-3231-0 | Other | MI | BC/BS OF MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301012697 (Michigan) | Primary |
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