Provider Demographics
NPI:1699757807
Name:TOWNSEND, PATRICIA JOANNE
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JOANNE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:JOANNE
Other - Last Name:DAUSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD
Mailing Address - Street 1:427 SEMINOLE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3747
Mailing Address - Country:US
Mailing Address - Phone:231-739-8800
Mailing Address - Fax:231-739-8805
Practice Address - Street 1:427 SEMINOLE RD
Practice Address - Street 2:SUITE201
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-3747
Practice Address - Country:US
Practice Address - Phone:231-739-8800
Practice Address - Fax:231-739-8805
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301001342103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0*M22640Medicare ID - Type UnspecifiedPSYCHOLOGIST