| Peaceful Banyan | |
|
409 Plymouth Rd Ste 270 Plymouth MI 48170-1842 | |
| (248) 444-5479 | |
| Not Available |
| Full Name | Peaceful Banyan |
|---|---|
| Speciality | Psychologist |
| Location | 409 Plymouth Rd Ste 270, Plymouth, Michigan |
| Authorized Official Name and Position | Anne Marie Caldwell (SOLE MEMBER) |
| Authorized Official Contact | 2484445479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peaceful Banyan 409 Plymouth Rd Ste 270 Plymouth MI 48170-1842 Ph: (248) 444-5479 | Peaceful Banyan 409 Plymouth Rd Ste 270 Plymouth MI 48170-1842 Ph: (248) 444-5479 |
| NPI Number | 1194348458 |
|---|---|
| Provider Enumeration Date | 05/21/2020 |
| Last Update Date | 05/21/2020 |
| Certification Date | 05/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194348458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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