| Rising Up Psychological Services Pllc | |
|
112 W Washington St Ste D Marquette MI 49855-4367 | |
| (906) 869-8003 | |
| Not Available |
| Full Name | Rising Up Psychological Services Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 112 W Washington St Ste D, Marquette, Michigan |
| Authorized Official Name and Position | Emily Elizabeth Depetro (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 9068698003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Up Psychological Services Pllc 2202 Fitch Ave Marquette MI 49855-1704 Ph: (906) 869-8003 | Rising Up Psychological Services Pllc 112 W Washington St Ste D Marquette MI 49855-4367 Ph: (906) 869-8003 |
| NPI Number | 1295456366 |
|---|---|
| Provider Enumeration Date | 09/07/2022 |
| Last Update Date | 09/07/2022 |
| Certification Date | 09/07/2022 |
| Medicare PECOS PAC ID | 3678940855 |
|---|---|
| Medicare Enrollment ID | O20221031002940 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295456366 | NPI | - | NPPES |
| Provider Name | Emily Elizabeth Depetro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588385686 PECOS PAC ID: 4587031760 Enrollment ID: I20221031002977 |
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