Provider Demographics
NPI:1144398504
Name:MIELKE & WEEKS, P. C.
Entity Type:Organization
Organization Name:MIELKE & WEEKS, P. C.
Other - Org Name:ROBERT MIELKE PHD & KATHLEEN WEEKS M A M S INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WEEKS
Authorized Official - Last Name:MIELKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-828-1010
Mailing Address - Street 1:1880 STAR BATT DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3709
Mailing Address - Country:US
Mailing Address - Phone:248-828-1010
Mailing Address - Fax:248-828-1010
Practice Address - Street 1:1880 STAR BATT DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3709
Practice Address - Country:US
Practice Address - Phone:248-828-1010
Practice Address - Fax:248-828-1010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006282103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty