Basic Information
| Provider Information | |||||||||
| NPI: | 1841436375 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCGARRITY | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | MAREE | ||||||||
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| Credential: | MA LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 559 W GRAND BLVD | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482162200 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 18917 JOY RD | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482283050 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3134468800 | ||||||||
| FaxNumber: | 3134468810 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2009 | ||||||||
| LastUpdateDate: | 05/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 6301012107 | MI | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103T00000X | 6361003317 | MI | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.