| Thriving Pineapple | |
|
23650 Woodward Ave Ste 109 Pleasant Ridge MI 48069-1141 | |
| (248) 219-6627 | |
| Not Available |
| Full Name | Thriving Pineapple |
|---|---|
| Speciality | Psychologist |
| Location | 23650 Woodward Ave Ste 109, Pleasant Ridge, Michigan |
| Authorized Official Name and Position | Corinne Rogers (OWNER) |
| Authorized Official Contact | 2482196627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thriving Pineapple 23650 Woodward Ave Ste 109 Pleasant Ridge MI 48069-1141 Ph: (248) 219-6627 | Thriving Pineapple 23650 Woodward Ave Ste 109 Pleasant Ridge MI 48069-1141 Ph: (248) 219-6627 |
| NPI Number | 1053896746 |
|---|---|
| Provider Enumeration Date | 09/27/2018 |
| Last Update Date | 10/15/2019 |
| Medicare PECOS PAC ID | 7214278134 |
|---|---|
| Medicare Enrollment ID | O20190402002984 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053896746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Corinne Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467495275 PECOS PAC ID: 8527156702 Enrollment ID: I20071126000117 |
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