Jenni Knowles, Ph.d., Lp, Llc | |
200 E Big Beaver Rd # 116 Troy MI 48083-1208 | |
(248) 320-1196 | |
Not Available |
Full Name | Jenni Knowles, Ph.d., Lp, Llc |
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Speciality | Psychologist |
Location | 200 E Big Beaver Rd # 116, Troy, Michigan |
Authorized Official Name and Position | Linda Knowles (SOLE PROPRIETOR) |
Authorized Official Contact | 2483201196 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jenni Knowles, Ph.d., Lp, Llc 6633 Ellinwood Dr White Lake MI 48383-3083 Ph: (248) 320-1196 | Jenni Knowles, Ph.d., Lp, Llc 200 E Big Beaver Rd # 116 Troy MI 48083-1208 Ph: (248) 320-1196 |
NPI Number | 1336409804 |
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Provider Enumeration Date | 05/18/2012 |
Last Update Date | 05/18/2012 |
Medicare PECOS PAC ID | 3971755109 |
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Medicare Enrollment ID | O20121214000074 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336409804 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 6301014248 (Michigan) | Primary |
Provider Name | Linda L Knowles |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1043431141 PECOS PAC ID: 3173791787 Enrollment ID: I20110727000132 |
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