Provider Demographics
NPI:1083821953
Name:AVI-YONAH, ORLI KLIER (PHD)
Entity Type:Individual
Prefix:
First Name:ORLI
Middle Name:KLIER
Last Name:AVI-YONAH
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 1:400 MAYNARD ST
Mailing Address - Street 2:#1003
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2440
Mailing Address - Country:US
Mailing Address - Phone:734-769-2333
Mailing Address - Fax:
Practice Address - Street 1:400 MAYNARD ST
Practice Address - Street 2:#1003
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2440
Practice Address - Country:US
Practice Address - Phone:734-769-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011533103T00000X, 103TC0700X
MI68010836511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical