| Emotional Fitness Center Pc | |
|
2440 Shawood St Novi MI 48377-1970 | |
| (248) 921-7922 | |
| Not Available |
| Full Name | Emotional Fitness Center Pc |
|---|---|
| Speciality | Psychologist |
| Location | 2440 Shawood St, Novi, Michigan |
| Authorized Official Name and Position | M. Lynn Vaughn (OWNER) |
| Authorized Official Contact | 2489217922 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emotional Fitness Center Pc 2440 Shawood St Novi MI 48377-1970 Ph: (248) 921-7922 | Emotional Fitness Center Pc 2440 Shawood St Novi MI 48377-1970 Ph: (248) 921-7922 |
| NPI Number | 1790120897 |
|---|---|
| Provider Enumeration Date | 05/02/2013 |
| Last Update Date | 05/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790120897 | NPI | - | NPPES |
| 1346292794 | Other | MI | IND NPI |
| 6301006411 | Other | MI | LIC # |
| 680F38144 | Other | MI | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301006411 (Michigan) | Primary |
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