Provider Demographics
NPI:1497091565
Name:CRAIG, ERIC E (LLP)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:E
Last Name:CRAIG
Suffix:
Gender:M
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3383 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:MI
Mailing Address - Zip Code:48455-8968
Mailing Address - Country:US
Mailing Address - Phone:810-406-1660
Mailing Address - Fax:256-970-1643
Practice Address - Street 1:3383 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455-8968
Practice Address - Country:US
Practice Address - Phone:810-406-1660
Practice Address - Fax:256-970-1643
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008537103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist