Provider Demographics
NPI:1477736866
Name:CAROLE M ROWLAND PHD PLLC
Entity Type:Organization
Organization Name:CAROLE M ROWLAND PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-284-6204
Mailing Address - Street 1:3505 BIDDLE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-6559
Mailing Address - Country:US
Mailing Address - Phone:734-324-0021
Mailing Address - Fax:
Practice Address - Street 1:3505 BIDDLE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-6559
Practice Address - Country:US
Practice Address - Phone:734-324-0021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009216103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherCOMMERCIAL
MI0N66840Medicare PIN