Provider Demographics
NPI:1932573383
Name:DONNA MARIE D. MESZAROS, PH.D., LP PLLC
Entity Type:Organization
Organization Name:DONNA MARIE D. MESZAROS, PH.D., LP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA MARIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MESZAROS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-751-2921
Mailing Address - Street 1:46417 KILLARNEY CIR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-3501
Mailing Address - Country:US
Mailing Address - Phone:734-751-2921
Mailing Address - Fax:
Practice Address - Street 1:37677 PROFESSIONAL CENTER DR
Practice Address - Street 2:SUITE 125C
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1192
Practice Address - Country:US
Practice Address - Phone:734-751-2921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009817103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty