| Sage Tree Psychology Group Llc | |
|
925 N Lapeer Rd Ste 151 Oxford MI 48371-6742 | |
| (248) 303-1382 | |
| Not Available |
| Full Name | Sage Tree Psychology Group Llc |
|---|---|
| Speciality | Psychologist |
| Location | 925 N Lapeer Rd, Oxford, Michigan |
| Authorized Official Name and Position | Dawn Bane Gventer (PSYCHOLOGIST) |
| Authorized Official Contact | 2483031382 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Tree Psychology Group Llc 1179 Bellwood Ct Oxford MI 48371-6732 Ph: (248) 303-1382 | Sage Tree Psychology Group Llc 925 N Lapeer Rd Ste 151 Oxford MI 48371-6742 Ph: (248) 303-1382 |
| NPI Number | 1265979397 |
|---|---|
| Provider Enumeration Date | 01/26/2017 |
| Last Update Date | 01/28/2017 |
| Medicare PECOS PAC ID | 7416230792 |
|---|---|
| Medicare Enrollment ID | O20170210002122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265979397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301013477 (Michigan) | Primary |
| Provider Name | Dawn Gventer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669470266 PECOS PAC ID: 3678478401 Enrollment ID: I20090317000182 |
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