Provider Demographics
NPI:1760545065
Name:INTEGRATED ENTERPRISES,P.C.
Entity Type:Organization
Organization Name:INTEGRATED ENTERPRISES,P.C.
Other - Org Name:HARRIET J. MALL, PH.D., P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:J
Authorized Official - Last Name:MALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-538-5045
Mailing Address - Street 1:30445 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3158
Mailing Address - Country:US
Mailing Address - Phone:248-538-5045
Mailing Address - Fax:
Practice Address - Street 1:30445 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 240
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3158
Practice Address - Country:US
Practice Address - Phone:248-538-5045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005154101YP2500X
MI6301008104103G00000X, 103T00000X, 103TA0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11643507OtherCAQH
MI1558441840OtherNPI