| Hope Laboratory, Inc | |
|
16250 Northland Dr Ste 204 Southfield MI 48075-5226 | |
| (415) 336-7707 | |
| Not Available |
| Full Name | Hope Laboratory, Inc |
|---|---|
| Speciality | Psychologist - School |
| Location | 16250 Northland Dr Ste 204, Southfield, Michigan |
| Authorized Official Name and Position | Dante Demitrius Dixson (PRESIDENT) |
| Authorized Official Contact | 4153367707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope Laboratory, Inc 3070 Whisperwood Dr Apt 417 Ann Arbor MI 48105-3419 Ph: () - | Hope Laboratory, Inc 16250 Northland Dr Ste 204 Southfield MI 48075-5226 Ph: (415) 336-7707 |
| NPI Number | 1740844182 |
|---|---|
| Provider Enumeration Date | 04/30/2019 |
| Last Update Date | 04/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740844182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Secondary |
| 103TS0200X | Psychologist - School | (* (Not Available)) | Primary |
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