Provider Demographics
NPI:1578780789
Name:RUBIN, STEVEN LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LEE
Last Name:RUBIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 E LIBERTY ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2157
Mailing Address - Country:US
Mailing Address - Phone:734-994-3877
Mailing Address - Fax:734-662-8393
Practice Address - Street 1:103 E LIBERTY ST
Practice Address - Street 2:SUITE 209
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2157
Practice Address - Country:US
Practice Address - Phone:734-994-3877
Practice Address - Fax:734-662-8393
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006409103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical