Individuallytics, INC.
Internal Medicine in Ann Arbor, MI. Organization (NPI-2).
NPI number1164078648
StatusActive
Last updated in NPPESJul 29, 2020
Details
- NPI
- 1164078648
- Entity type
- Organization (NPI-2)
- Legal business name
- Individuallytics, INC.
- Organization subpart
- No
- Enumeration date
- Aug 12, 2019
- Certification date
- Jul 29, 2020
- Last updated
- Jul 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 103T00000X | Psychologist | – | – | |
| 103TC0700X | Psychologist, Clinical | – | – | |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 2083P0901X | Preventive Medicine, Public Health & General Preventive Medicine | – | – |
Other names
- Individuallytics Connected Care (Doing Business As)
Practice location
330 E Liberty StAnn Arbor, MI 48104-2274
Phone 248-505-3175
Mailing address
3765 Sancroft AveWest Bloomfield, MI 48324-2658
Other practice locations
46701 Commerce Center Dr
Plymouth, MI 48170-2475
Plymouth, MI 48170-2475
Phone 248-432-0175
Authorized official
Dennis Nash
President
2484320175
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