Provider Demographics
NPI:1760880025
Name:INTROSPECTIONS LLC
Entity Type:Organization
Organization Name:INTROSPECTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SELF
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLIAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:586-776-8885
Mailing Address - Street 1:37399 GARFIELD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3672
Mailing Address - Country:US
Mailing Address - Phone:586-776-8885
Mailing Address - Fax:
Practice Address - Street 1:37399 GARFIELD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-3672
Practice Address - Country:US
Practice Address - Phone:586-776-8885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010799871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty