Provider Demographics
NPI:1649461047
Name:ANNE M. YURIK, PH.D, P.C.
Entity type:Organization
Organization Name:ANNE M. YURIK, PH.D, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:YURIK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-299-4315
Mailing Address - Street 1:563 BOLINGER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2818
Mailing Address - Country:US
Mailing Address - Phone:248-299-4315
Mailing Address - Fax:
Practice Address - Street 1:200 DIVERSION ST STE 150
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2245
Practice Address - Country:US
Practice Address - Phone:248-299-4315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007587251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health