Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. PHILIP CHARLES LIETHEN, PHD
ActiveDR. PHILIP CHARLES LIETHEN, PHD is a Clinical Neuropsychologist healthcare provider located in FORT GRATIOT, Michigan. NPI 1689659526 is currently active in the NPPES registry. Verify at CMS.
Clinical Neuropsychologist · FORT GRATIOT, MI
Registration Details
- NPI Number
- 1689659526
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 14, 2005 (20.708252762632 yrs)
- Last Updated
- Jul 8, 2007
- Licenses
-
3063 (MI)2082 (WI)
Practice Information
- Address
-
2616 WHITNEY PLFORT GRATIOT, MI, 480593952Browse MI providers · Browse ZIP 48059
- Phone
- 5862465746
- Primary Specialty
-
Clinical Neuropsychologist
103G00000X
- Additional Specialty
- Clinical Neuropsychologist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.