Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 6301016085 | MI |
N | 103TC0700X | Clinical Psychologist | 6301016085 | MI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6301016085 | MI |
Y | 103G00000X | Clinical Psychologist | 6301016085 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301016085 | MI |
N | 103TP2701X | Group Psychotherapist | 6301016085 | MI |
N | 103TR0400X | Rehabilitation Psychologist | 6301016085 | MI |
NPI | 1447643382 |
---|---|
Provider Name | Ms. Robin Nicole Annis |
First Address | Ann Arbor, MI 48104-5131 |
Second Address | Ann Arbor, MI 48104-5131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2015 |
Last Update Date | 17/03/2015 |