Provider Demographics
NPI:1396902367
Name:AUMANN, CONRAD MARTIN II (PHD)
Entity type:Individual
Prefix:DR
First Name:CONRAD
Middle Name:MARTIN
Last Name:AUMANN
Suffix:II
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:23022 SANDERS ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2134
Mailing Address - Country:US
Mailing Address - Phone:586-776-7308
Mailing Address - Fax:
Practice Address - Street 1:22301 GREATER MACK AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2376
Practice Address - Country:US
Practice Address - Phone:586-445-1442
Practice Address - Fax:586-445-1446
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006530101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional