| Maple Psychiatric Associates, P.c. | |
|
5640 W Maple Rd Ste 310 West Bloomfield MI 48322-3719 | |
| (248) 932-0290 | |
| (248) 932-0358 |
| Full Name | Maple Psychiatric Associates, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 5640 W Maple Rd Ste 310, West Bloomfield, Michigan |
| Authorized Official Name and Position | Kathleen Michelle Brazzle (PSYCHIATRIST) |
| Authorized Official Contact | 2489320290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maple Psychiatric Associates, P.c. 5640 W Maple Rd Ste 310 West Bloomfield MI 48322-3719 Ph: (248) 932-0290 | Maple Psychiatric Associates, P.c. 5640 W Maple Rd Ste 310 West Bloomfield MI 48322-3719 Ph: (248) 932-0290 |
| NPI Number | 1932382181 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 12/11/2007 |
| Medicare PECOS PAC ID | 8820030125 |
|---|---|
| Medicare Enrollment ID | O20050526000480 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932382181 | NPI | - | NPPES |
| Provider Name | Kathleen Michelle Fouche Brazzle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629057906 PECOS PAC ID: 7810939113 Enrollment ID: I20050526000511 |
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