| Mr Ricky Lee Jentons, MALLP | |
|
18181 Oakwood Blvd, 311, Dearborn, MI 48124-5032 | |
| (313) 271-8170 | |
| (313) 271-8353 |
| Full Name | Mr Ricky Lee Jentons |
|---|---|
| Gender | Male |
| Speciality | Psychologist - Clinical |
| Location | 18181 Oakwood Blvd, Dearborn, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922297076 | NPI | - | NPPES |
| 0N15280 | Other | MI | APEX BEHAVIORAL HEALTH P.L.L.C. MEDICARE GROUP PIN NO. |
| 6301005971 | Other | MI | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | 6301005971 (Michigan) | Secondary |
| 103TC0700X | Psychologist - Clinical | 6301005971 (Michigan) | Primary |
| Entity Name | Victor M. Cruz MD, P.C. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023036514 PECOS PAC ID: 3375604952 Enrollment ID: O20081202000484 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Ricky Lee Jentons, MALLP 18181 Oakwood Blvd, 311, Dearborn, MI 48124-5032 Ph: (313) 271-8170 | Mr Ricky Lee Jentons, MALLP 18181 Oakwood Blvd, 311, Dearborn, MI 48124-5032 Ph: (313) 271-8170 |
Sara Pierce, M.S., TLLP Psychologist Medicare: Medicare Enrolled Practice Location: 835 Mason St Ste B220, Dearborn, MI 48124 Phone: 313-561-9064 |
Ms. Jessica Dawn Clemons, MA, TLLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1 Parklane Blvd Ste 200e, Dearborn, MI 48126 Phone: 313-846-2606 Fax: 313-846-2657 |
Yasmeen Saba El-masry, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 835 Mason St Ste B220, Dearborn, MI 48124 Phone: 313-561-9064 |
Kalee Lapointe, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 835 Mason St Ste D160, Dearborn, MI 48124 Phone: 325-716-5223 |
Mr. Giovanni Vitale Ii, LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 23061 Nona St, Dearborn, MI 48124 Phone: 313-969-7750 |
Layla Obad, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 835 Mason St Ste B220, Dearborn, MI 48124 Phone: 313-561-9064 |
Karli Aliya Carpenter, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 19855 Outer Dr Ste 300, Dearborn, MI 48124 Phone: 313-359-1977 Fax: 313-730-1677 |