Provider Demographics
NPI:1912177932
Name:BARCLAY, ANDREW M (PHD)
Entity Type:Individual
Prefix:PROF
First Name:ANDREW
Middle Name:M
Last Name:BARCLAY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9029 W SCENIC LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LAINGSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48848-8785
Mailing Address - Country:US
Mailing Address - Phone:517-651-2661
Mailing Address - Fax:517-651-9632
Practice Address - Street 1:9029 W SCENIC LAKE DR
Practice Address - Street 2:
Practice Address - City:LAINGSBURG
Practice Address - State:MI
Practice Address - Zip Code:48848-8785
Practice Address - Country:US
Practice Address - Phone:517-651-2661
Practice Address - Fax:517-651-9632
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007781103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist