Provider Demographics
NPI:1093190100
Name:ASPIRE THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:ASPIRE THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDAL
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-739-0760
Mailing Address - Street 1:PO BOX 3380
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-3380
Mailing Address - Country:US
Mailing Address - Phone:248-624-8181
Mailing Address - Fax:855-624-8161
Practice Address - Street 1:37000 GRAND RIVER AVE STE 325
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2868
Practice Address - Country:US
Practice Address - Phone:248-624-8181
Practice Address - Fax:855-624-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007332103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty