Basic Information
| Provider Information | |||||||||
| NPI: | 1770770612 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCAULIFFE | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.S. LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1308 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481702253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344513440 | ||||||||
| FaxNumber: | 7344518726 | ||||||||
| Practice Location | |||||||||
| Address1: | 1308 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481702253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344513440 | ||||||||
| FaxNumber: | 7344518726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2007 | ||||||||
| LastUpdateDate: | 09/15/2011 | ||||||||
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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 | 103TC0700X | 6301013323 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.