Provider Demographics
NPI:1316524358
Name:MIND OPENED THERAPY AND PSYCHOLOGICAL EVALUATIONS PLLC
Entity type:Organization
Organization Name:MIND OPENED THERAPY AND PSYCHOLOGICAL EVALUATIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGIOIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-378-4163
Mailing Address - Street 1:804 WOODSTOCK LN
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-7549
Mailing Address - Country:US
Mailing Address - Phone:248-378-4163
Mailing Address - Fax:
Practice Address - Street 1:2725 PACKARD ST STE 102
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3443
Practice Address - Country:US
Practice Address - Phone:248-378-4163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty