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DR. JOHN BRADLEY CARROLL PH.D.

Clinical Neuropsychologist

Farmington Hills, Michigan

Provider NPI: 1952549891

Provider Information:
DR. JOHN BRADLEY CARROLL PH.D.
Gender: M
Sole Proprietor


Practice Location:
31500 W 13 MILE RD #111 FARMINGTON HILLS, MI 48334 US
Tel: 248-855-9220  Fax: 248-855-3866

Business Mailing Address:
PO BOX 2689 2311 E. STADIUM BLVD ANN ARBOR, MI 48106 US
Tel: 734-761-9835  Fax: 248-855-3866

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
MI6301007077
Y103TC2200XBehavioral Health & Social Service Providers
Psychologist

Other Provider Identifiers:

IssuerNumberStateType
BCBS OF MICHIGAN68-0-F3-3086-0MI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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