Provider Demographics
NPI:1164877726
Name:THERABEE
Entity Type:Organization
Organization Name:THERABEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEZAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:LLP
Authorized Official - Phone:586-789-9748
Mailing Address - Street 1:2035 HOGBACK RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9732
Mailing Address - Country:US
Mailing Address - Phone:586-789-9748
Mailing Address - Fax:
Practice Address - Street 1:2035 HOGBACK RD
Practice Address - Street 2:SUITE 108
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9732
Practice Address - Country:US
Practice Address - Phone:586-789-9748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015800103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty