Dr Alicia Ellen Tisdale, PHD | |
5665 W Maple Rd, Suite A, West Bloomfield, MI 48322-3741 | |
(248) 626-8833 | |
(248) 626-8836 |
Full Name | Dr Alicia Ellen Tisdale |
---|---|
Gender | Female |
Speciality | Clinical Psychologist |
Experience | 36 Years |
Location | 5665 W Maple Rd, West Bloomfield, Michigan |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083622914 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 6301003007 (Michigan) | Primary |
Entity Name | Thomas Park M.d. Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881904605 PECOS PAC ID: 9032303813 Enrollment ID: O20101105000442 |
Mailing Address | Practice Location Address |
---|---|
Dr Alicia Ellen Tisdale, PHD 5101 Willow Pond Dr, West Bloomfield, MI 48323 Ph: (248) 706-1453 | Dr Alicia Ellen Tisdale, PHD 5665 W Maple Rd, Suite A, West Bloomfield, MI 48322-3741 Ph: (248) 626-8833 |
Ms. Karen Bango, LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6555 W Maple Rd, West Bloomfield, MI 48322 Phone: 248-592-2654 Fax: 248-592-2660 | |
Daniel Simmons, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6555 W Maple Rd, West Bloomfield, MI 48322 Phone: 248-592-2300 Fax: 248-592-2340 | |
Emma Fay Kelly, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 7035 Orchard Lake Rd Ste 800, West Bloomfield, MI 48322 Phone: 248-669-9500 | |
Mrs. Joan Frances Lazar, MA, LLP, LPC Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6024 W Maple Rd, Suite 107, West Bloomfield, MI 48322 Phone: 248-489-1550 Fax: 248-489-9767 | |
Dr. Katherine Ann Young, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1943 Windside, West Bloomfield, MI 48324 Phone: 248-681-5829 | |
Kimberly Elizabeth Zuteck, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5757 W Maple Rd Ste 800b, West Bloomfield, MI 48322 Phone: 586-574-5845 |