Provider Demographics
NPI:1073636692
Name:HERING, AUDREY M (PHD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:M
Last Name:HERING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 HONEY RUN DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9343
Mailing Address - Country:US
Mailing Address - Phone:734-769-8201
Mailing Address - Fax:734-769-8201
Practice Address - Street 1:202 E WASHINGTON ST
Practice Address - Street 2:SUITE 401
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2017
Practice Address - Country:US
Practice Address - Phone:734-645-5163
Practice Address - Fax:734-769-8201
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005561103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical