| Elena Brand, Ph.d., P.l.l.c. | |
|
36510 W 12 Mile Rd Farmington Hills MI 48331-3169 | |
| (248) 553-8220 | |
| (248) 553-8290 |
| Full Name | Elena Brand, Ph.d., P.l.l.c. |
|---|---|
| Speciality | Psychologist |
| Location | 36510 W 12 Mile Rd, Farmington Hills, Michigan |
| Authorized Official Name and Position | Elena Brand (OWNER) |
| Authorized Official Contact | 2485538220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elena Brand, Ph.d., P.l.l.c. 36510 W 12 Mile Rd Farmington Hills MI 48331-3169 Ph: (248) 553-8220 | Elena Brand, Ph.d., P.l.l.c. 36510 W 12 Mile Rd Farmington Hills MI 48331-3169 Ph: (248) 553-8220 |
| NPI Number | 1285833293 |
|---|---|
| Provider Enumeration Date | 07/11/2007 |
| Last Update Date | 07/11/2007 |
| Medicare PECOS PAC ID | 7517004724 |
|---|---|
| Medicare Enrollment ID | O20091021000054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285833293 | NPI | - | NPPES |
| 680F328500 | Other | MI | BLUE CROSS BLUE SHIELD OF |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301008683 (Michigan) | Primary |
| Provider Name | Elena F Brand |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194767848 PECOS PAC ID: 9436296647 Enrollment ID: I20091021000046 |
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