Patricia Laura Hanks, LLP

Individual provider Active NPI Cognitive & Behavioral Psychologist · Newport, MI

NPI 1386796746 · NPPES record last updated Jul 2, 2013

Key facts

NPI
1386796746
Entity type
Individual (NPI type 1)
Primary specialty
Cognitive & Behavioral Psychologist 103TB0200X
License
6301013233 (MI)
Practice address
6800 Lakeshore Dr
Newport, MI 48166-9716
Phone
(269) 605-9287
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
39001558AINMDMental Health Counselor
6301013233MIMDCognitive & Behavioral Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 6301013233 MI Yes
Mental Health Counselor 101YM0800X 39001558A IN

Addresses

Primary practice location

6800 Lakeshore Dr
Newport, MI 48166-9716

Mailing address

6800 Lakeshore Dr
Newport, MI 48166-9716
Phone (269) 605-9287

Other providers in Newport, MI

All providers in Newport, MI · Cognitive & Behavioral Psychologist in Michigan

Sources for this page

Verify at the official NPI Registry.