| Penelope Hale Phd Pc | |
|
19855 Outer Dr Suite 103w Dearborn MI 48124-2022 | |
| (313) 278-7777 | |
| (313) 359-9778 |
| Full Name | Penelope Hale Phd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 19855 Outer Dr, Dearborn, Michigan |
| Authorized Official Name and Position | Penelope A Hale (OWNER) |
| Authorized Official Contact | 3132787777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Penelope Hale Phd Pc 523 Barrington Rd Grosse Pointe Park MI 48230-1721 Ph: (313) 278-7777 | Penelope Hale Phd Pc 19855 Outer Dr Suite 103w Dearborn MI 48124-2022 Ph: (313) 278-7777 |
| NPI Number | 1346411220 |
|---|---|
| Provider Enumeration Date | 03/18/2008 |
| Last Update Date | 03/18/2008 |
| Medicare PECOS PAC ID | 4880772110 |
|---|---|
| Medicare Enrollment ID | O20080426000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346411220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301002422 (Michigan) | Primary |
| Provider Name | Penelope A Hale |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700961158 PECOS PAC ID: 3971681206 Enrollment ID: I20080426000015 |
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