Provider Demographics
NPI:1548720469
Name:ALOE INTEGRATIVE PSYCHOLOGY GROUP, PLLC
Entity type:Organization
Organization Name:ALOE INTEGRATIVE PSYCHOLOGY GROUP, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:MARIE-BUDRY
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:248-218-0588
Mailing Address - Street 1:2490 WALTON BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1484
Mailing Address - Country:US
Mailing Address - Phone:248-218-0622
Mailing Address - Fax:
Practice Address - Street 1:2490 WALTON BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1484
Practice Address - Country:US
Practice Address - Phone:248-218-0622
Practice Address - Fax:248-218-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health