| Lisa Lamancusa Ma, Llp | |
|
4829 E Beltline Ave Ne Ste 100 Grand Rapids MI 49525-9349 | |
| (616) 364-3301 | |
| Not Available |
| Full Name | Lisa Lamancusa Ma, Llp |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, Michigan |
| Authorized Official Name and Position | Lisa Lamancusa (BUSINESS OWNER) |
| Authorized Official Contact | 6163643301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Lamancusa Ma, Llp 4829 E Beltline Ave Ne Ste 100 Grand Rapids MI 49525-9349 Ph: (616) 364-3301 | Lisa Lamancusa Ma, Llp 4829 E Beltline Ave Ne Ste 100 Grand Rapids MI 49525-9349 Ph: (616) 364-3301 |
| NPI Number | 1124516000 |
|---|---|
| Provider Enumeration Date | 04/26/2018 |
| Last Update Date | 04/26/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124516000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 6301012462 (Michigan) | Primary |
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