Provider Demographics
NPI:1154365674
Name:HOWELL, FREDRICK P (PHD)
Entity type:Individual
Prefix:DR
First Name:FREDRICK
Middle Name:P
Last Name:HOWELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31584 SCHOOLCRAFT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1843
Mailing Address - Country:US
Mailing Address - Phone:734-427-0060
Mailing Address - Fax:734-427-0851
Practice Address - Street 1:31584 SCHOOLCRAFT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1843
Practice Address - Country:US
Practice Address - Phone:734-427-0060
Practice Address - Fax:734-427-0851
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI000803103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0H24596Medicare ID - Type Unspecified