| Michigan State University | |
|
909 Wilson Rd Rm B119 East Lansing MI 48824-6410 | |
| (517) 353-3070 | |
| (517) 432-3603 |
| Full Name | Michigan State University |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 909 Wilson Rd Rm B119, East Lansing, Michigan |
| Authorized Official Name and Position | Relanda Price (LEAD ENROLLMENT COORDINATOR) |
| Authorized Official Contact | 5178842976 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan State University 804 Service Rd Ste A109b East Lansing MI 48824-7015 Ph: (517) 353-3070 | Michigan State University 909 Wilson Rd Rm B119 East Lansing MI 48824-6410 Ph: (517) 353-3070 |
| NPI Number | 1164973418 |
|---|---|
| Provider Enumeration Date | 10/21/2016 |
| Last Update Date | 05/15/2023 |
| Certification Date | 05/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164973418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Michigan) | Primary |
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