Provider Demographics
NPI:1093373763
Name:AGNES WROBEL PSYCHIATRY PLLC
Entity type:Organization
Organization Name:AGNES WROBEL PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-673-1441
Mailing Address - Street 1:5036 DIXIE HWY # 261
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48330-0016
Mailing Address - Country:US
Mailing Address - Phone:248-673-1441
Mailing Address - Fax:888-599-0120
Practice Address - Street 1:41400 DEQUINDRE RD STE 121
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-3751
Practice Address - Country:US
Practice Address - Phone:586-843-3815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty