Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 6301016883 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301016883 | MI |
NPI | 1003359928 |
---|---|
Provider Name | Dr. Amy Paggeot |
First Address | Livonia, MI 48152-2693 |
Second Address | Ann Arbor, MI 48105-9341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2016 |
Last Update Date | 25/11/2016 |