| Lori Gray Boothroyd Pllc | |
|
12935 S West Bay Shore Dr Suite 200 Traverse City MI 49684-6298 | |
| (231) 929-4722 | |
| Not Available |
| Full Name | Lori Gray Boothroyd Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12935 S West Bay Shore Dr, Traverse City, Michigan |
| Authorized Official Name and Position | Lori Boothroyd (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2319294722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lori Gray Boothroyd Pllc 13351 S Partridge Run Dr Traverse City MI 49684-8485 Ph: (231) 929-4722 | Lori Gray Boothroyd Pllc 12935 S West Bay Shore Dr Suite 200 Traverse City MI 49684-6298 Ph: (231) 929-4722 |
| NPI Number | 1508001090 |
|---|---|
| Provider Enumeration Date | 12/11/2008 |
| Last Update Date | 08/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508001090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6301012397 (Michigan) | Primary |
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