| |
1516 Peck Street Muskegon Mi 49441 Muskegon MI 49441 | |
(231) 335-0952 | |
Not Available |
Full Name | |
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Speciality | Psychologist |
Location | 1516 Peck Street, Muskegon, Michigan |
Authorized Official Name and Position | Donna Florence Lamar (PSYCHOLOGIST/OWNER) |
Authorized Official Contact | 2313350952 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3196 Fenner Rd Muskegon MI 49445-1826 Ph: (231) 335-0952 | 1516 Peck Street Muskegon Mi 49441 Muskegon MI 49441 Ph: (231) 335-0952 |
NPI Number | 1639898968 |
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Provider Enumeration Date | 08/22/2022 |
Last Update Date | 04/04/2024 |
Certification Date | 04/04/2024 |
Medicare PECOS PAC ID | 9830631985 |
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Medicare Enrollment ID | O20240605000889 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639898968 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
Provider Name | Donna F Lamar |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1053388413 PECOS PAC ID: 0042264111 Enrollment ID: I20050310001033 |
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