| Interface I Pc | |
|
4170 Pontiac Lake Rd Waterford MI 48328-1282 | |
| (248) 674-2659 | |
| (248) 674-2659 |
| Full Name | Interface I Pc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 4170 Pontiac Lake Rd, Waterford, Michigan |
| Authorized Official Name and Position | Patricia Armstrong (OWNER) |
| Authorized Official Contact | 2486742659 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Interface I Pc 4170 Pontiac Lake Rd Waterford MI 48328-1282 Ph: (248) 674-2659 | Interface I Pc 4170 Pontiac Lake Rd Waterford MI 48328-1282 Ph: (248) 674-2659 |
| NPI Number | 1801912753 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 05/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801912753 | NPI | - | NPPES |
| 680F330170 | Other | MI | BCBSM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 6301007437 (Michigan) | Primary |
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