Individual provider · Type 1 NPI

Ryan Lee Blackstock, PSY.D., LP

Psychologist · Brownstown Township, MI

NPI number 1104014273 Active

Practice location

19366 Allen Rd, Suite C
Brownstown Township, MI 48183-6809

Fax (734) 479-1637

Mailing address

9237 Becker Ave
Allen Park, MI 48101-1563

Specialties and licenses

TaxonomyCodeLicense
Psychologist Primary 103T00000X6301013412 (MI)

Psychologist: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustmen…

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About NPI 1104014273

Ryan Lee Blackstock, PSY.D., LP's National Provider Identifier is 1104014273, issued on Oct 13, 2007. The primary taxonomy on file is Psychologist (103T00000X), and the practice location is in Brownstown Township, MI. The record was last updated on Aug 27, 2010.