Basic Information
| Provider Information | |||||||||
| NPI: | 1730565169 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARIS | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | FRANCES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4905 BOYNE CITY RD | ||||||||
| Address2: | |||||||||
| City: | BOYNE CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497129217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2315827354 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 990 GARFIELD WOODS DR | ||||||||
| Address2: | SUITE B | ||||||||
| City: | TRAVERSE CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 496865160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2316684909 | ||||||||
| FaxNumber: | 2319431334 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2015 | ||||||||
| LastUpdateDate: | 08/07/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 6301010284 | MI | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.