Provider Demographics
NPI:1336413749
Name:CARETTO, ANTONIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIA
Middle Name:
Last Name:CARETTO
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:PO BOX 2265
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48123-2265
Mailing Address - Country:US
Mailing Address - Phone:248-553-9053
Mailing Address - Fax:248-553-9053
Practice Address - Street 1:25882 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1292
Practice Address - Country:US
Practice Address - Phone:248-553-9053
Practice Address - Fax:248-553-9053
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008562103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical