Basic Information
| Provider Information | |||||||||
| NPI: | 1790863173 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEADOW | ||||||||
| FirstName: | AUROLEE | ||||||||
| MiddleName: | SHARON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20372 FOX | ||||||||
| Address2: | |||||||||
| City: | REDFORD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482401204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346201240 | ||||||||
| FaxNumber: | 3137669106 | ||||||||
| Practice Location | |||||||||
| Address1: | 340 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481701249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344543560 | ||||||||
| FaxNumber: | 7344543570 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 6301009293 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.