Provider Demographics
NPI:1346383130
Name:OBRIEN, PATRICIA EILEEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:EILEEN
Last Name:OBRIEN
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 1:46360 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48051-2800
Mailing Address - Country:US
Mailing Address - Phone:158-694-8022
Mailing Address - Fax:586-948-0213
Practice Address - Street 1:46360 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-2800
Practice Address - Country:US
Practice Address - Phone:158-694-8022
Practice Address - Fax:586-948-0213
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008644103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist