| Dr. Julianne S. Lark, Plc | |
|
4021 W Main St Suite 100 Kalamazoo MI 49006-3706 | |
| (269) 384-6055 | |
| (269) 384-6056 |
| Full Name | Dr. Julianne S. Lark, Plc |
|---|---|
| Speciality | Psychologist |
| Location | 4021 W Main St, Kalamazoo, Michigan |
| Authorized Official Name and Position | Julianne S. Lark (OWNER) |
| Authorized Official Contact | 2693846055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Julianne S. Lark, Plc 4021 W Main St Suite 100 Kalamazoo MI 49006-3706 Ph: (269) 384-6055 | Dr. Julianne S. Lark, Plc 4021 W Main St Suite 100 Kalamazoo MI 49006-3706 Ph: (269) 384-6055 |
| NPI Number | 1447681788 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 12/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447681788 | NPI | - | NPPES |
| 68-0-C9-4634-0 | Other | MI | BLUE CROSS BLUE SHIELD PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301008518 (Michigan) | Primary |
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