| Nebulous Awakening, Pllc | |
|
100 W Big Beaver Rd Ste 200 Troy MI 48084-5283 | |
| (248) 266-5942 | |
| Not Available |
| Full Name | Nebulous Awakening, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 100 W Big Beaver Rd Ste 200, Troy, Michigan |
| Authorized Official Name and Position | Jennifer Ishaq (OWNER) |
| Authorized Official Contact | 2487490029 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nebulous Awakening, Pllc 100 W Big Beaver Rd Ste 200 Troy MI 48084-5283 Ph: () - | Nebulous Awakening, Pllc 100 W Big Beaver Rd Ste 200 Troy MI 48084-5283 Ph: (248) 266-5942 |
| NPI Number | 1699512509 |
|---|---|
| Provider Enumeration Date | 07/09/2024 |
| Last Update Date | 07/09/2024 |
| Certification Date | 07/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699512509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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