Gayle Gozdor, PH.D. P.C.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301007615 Issued in MI

Legal business name

GAYLE GOZDOR, PH.D. P.C.

Practice address

2881 Monroe St
Suite 201C
Dearborn, MI 48124-3475

Phone

(313) 730-2077

Fax

(248) 562-7719

NPI assigned

Mar 10, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gayle Ann Gozdor, PH.D.

Title

Clinical Psychologist

Phone

(313) 730-2077

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316995200000",
    "number": "1407026115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2881 MONROE ST",
            "address_2": "SUITE 201C",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243475",
            "telephone_number": "313-730-2077",
            "fax_number": "248-562-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2881 MONROE ST",
            "address_2": "SUITE 201C",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243475",
            "telephone_number": "313-730-2077",
            "fax_number": "248-562-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAYLE GOZDOR, PH.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2011-09-26",
        "status": "A",
        "authorized_official_last_name": "GOZDOR",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "313-730-2077",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301007615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0F30675",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.