Provider Demographics
NPI:1629230743
Name:SIDELINKER, DON (PHD, MA)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:SIDELINKER
Suffix:
Gender:M
Credentials:PHD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 TOUCAN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3468
Mailing Address - Country:US
Mailing Address - Phone:248-844-9249
Mailing Address - Fax:248-844-9249
Practice Address - Street 1:272 TOUCAN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3468
Practice Address - Country:US
Practice Address - Phone:248-844-9249
Practice Address - Fax:248-844-9249
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009465101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor