Phunwutikorn, Patchawan
Phunwutikorn, Patchawan is an sole proprietor health care provider with primary practice located at 1 Genesys Pkwy , Grand Blanc MI 48439-8065. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Phunwutikorn, Patchawan can be contacted via phone (810) 606-5126.Contact Information
Primary practice address
1 Genesys Pkwy
Grand Blanc MI 48439-8065
Phone: (810) 606-5126
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X |
Profile Details
| NPI number | 1114455706 |
|---|---|
| LBN Legal business name | Phunwutikorn, Patchawan |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 26th, 2017 |
| Last updated | Aug 17th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114455706 | NPPES |
| California | MEDICAID | 8121 |
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