Provider Demographics
NPI:1689054595
Name:THOMAS S. ROSENBAUM, PH.D. & ASSOC
Entity Type:Organization
Organization Name:THOMAS S. ROSENBAUM, PH.D. & ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DELPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-677-0200
Mailing Address - Street 1:2725 PACKARD ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-3318
Mailing Address - Country:US
Mailing Address - Phone:734-677-0200
Mailing Address - Fax:
Practice Address - Street 1:2725 PACKARD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3318
Practice Address - Country:US
Practice Address - Phone:734-677-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301001432103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty