Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 6301008677 | MI |
N | 103T00000X | Psychologist | 6301008677 | MI |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 6301008677 | MI |
N | 103TA0700X | Adult Development & Aging Psychologist | 6301008677 | MI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6301008677 | MI |
Y | 103G00000X | Clinical Psychologist | 6301008677 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301008677 | MI |
N | 103TC1900X | Counseling Psychologist | 6301008677 | MI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 6301008677 | MI |
N | 103TF0000X | Family Psychologist | 6301008677 | MI |
N | 103TH0004X | Health Psychologist | 6301008677 | MI |
N | 103TH0100X | Health Service | 6301008677 | MI |
N | 103TP2701X | Group Psychotherapist | 6301008677 | MI |
NPI | 1619391299 |
---|---|
Provider Name | David Schroat |
First Address | Mount Clemens, MI 48043-2252 |
Second Address | Mount Clemens, MI 48043-2252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2014 |
Last Update Date | 09/01/2017 |