Provider Demographics
NPI:1659521326
Name:STEVEN PUTNAM & ASSOCIATES
Entity Type:Organization
Organization Name:STEVEN PUTNAM & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PUTNAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-769-6323
Mailing Address - Street 1:2651 N WAGNER RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-1761
Mailing Address - Country:US
Mailing Address - Phone:734-769-6323
Mailing Address - Fax:734-769-6323
Practice Address - Street 1:2651 N WAGNER RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-1761
Practice Address - Country:US
Practice Address - Phone:734-769-6323
Practice Address - Fax:734-769-6323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty