Provider Demographics
NPI:1659738664
Name:DML PSYCHOLOGICAL SERVICES PLLC
Entity Type:Organization
Organization Name:DML PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:LENO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-743-7434
Mailing Address - Street 1:39532 KARTAR LN
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-4520
Mailing Address - Country:US
Mailing Address - Phone:734-743-7434
Mailing Address - Fax:
Practice Address - Street 1:39532 KARTAR LN
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-4520
Practice Address - Country:US
Practice Address - Phone:734-743-7434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013798103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1770818577OtherINDIVIDUAL NPI