Provider Demographics
NPI:1952463671
Name:PLOPA, PATRICIA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:PLOPA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 PICKERING RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3631
Mailing Address - Country:US
Mailing Address - Phone:248-737-6417
Mailing Address - Fax:248-737-6417
Practice Address - Street 1:4655 PICKERING RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-3631
Practice Address - Country:US
Practice Address - Phone:248-737-6417
Practice Address - Fax:248-737-6417
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301 002100103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1600-2949OtherAMERICAN PSYCHOLOGICAL AS
MI23357OtherNATIONAL REGISTER
MI6301 002100OtherPSYCHOLOGIST LICENSE
MI23357OtherNATIONAL REGISTER
MIR67016Medicare UPIN