Provider Demographics
NPI:1700372570
Name:MIKA HANDELMAN PHD PLLC
Entity Type:Organization
Organization Name:MIKA HANDELMAN PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-939-8915
Mailing Address - Street 1:4017 CHESTER DR APT 212
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-7240
Mailing Address - Country:US
Mailing Address - Phone:415-939-8915
Mailing Address - Fax:
Practice Address - Street 1:2385 S HURON PKWY STE 2N
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5127
Practice Address - Country:US
Practice Address - Phone:415-939-8915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-05
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016807261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health