NPI 1003988528

Mary E Theisen-Goodvich, PHD

Practitioner Clinical Psychologist Ann Arbor, MI

Practice location

Address: 325 E Eisenhower Pkwy STE 300, Ann Arbor, MI 48108-3439
Phone: (734) 936-7175
Mailing address: 3621 S State St, Ann Arbor, MI 48108-1633

Registered specialties (2)

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 6301009981 (MI)

Other Psychologist providers in Michigan →

Psychologist

Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence 6301009981 (MI)

Registry record

NPI: 1003988528
Entity type: Individual
Sex (as registered): Female
NPI issued: 14 Nov 2006
Record last updated: 28 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.