Provider Demographics
NPI:1316136054
Name:BACHMANN PSYCHOLOGICAL CONSULTANTS P.C.
Entity type:Organization
Organization Name:BACHMANN PSYCHOLOGICAL CONSULTANTS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDOLPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:BACHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:517-545-0412
Mailing Address - Street 1:121 S BARNARD ST STE 3
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-2939
Mailing Address - Country:US
Mailing Address - Phone:517-545-0412
Mailing Address - Fax:
Practice Address - Street 1:121 S BARNARD ST STE 3
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2939
Practice Address - Country:US
Practice Address - Phone:517-545-0412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301001548103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P21800Medicare PIN