Basic Information
Provider Information
NPI: 1003291105
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BILLINGS
FirstName: NIA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHD, LP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 515 N MICHIGAN AVE
Address2:  
City: SAGINAW
State: MI
PostalCode: 486024316
CountryCode: US
TelephoneNumber: 9895832729
FaxNumber: 9895832843
Practice Location
Address1: 515 N MICHIGAN AVE
Address2:  
City: SAGINAW
State: MI
PostalCode: 486024316
CountryCode: US
TelephoneNumber: 9895832729
FaxNumber: 9895832843
Other Information
ProviderEnumerationDate: 07/30/2015
LastUpdateDate: 11/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X6301018776MIY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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