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5380 Holiday Ter Kalamazoo MI 49009-2154 | |
(269) 372-0961 | |
(269) 372-1612 |
Full Name | |
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Speciality | Psychologist - Counseling |
Location | 5380 Holiday Ter, Kalamazoo, Michigan |
Authorized Official Name and Position | Ronald Bruce Grant (OWNER) |
Authorized Official Contact | 2693720961 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5380 Holiday Ter Kalamazoo MI 49009-2154 Ph: (269) 372-0961 | 5380 Holiday Ter Kalamazoo MI 49009-2154 Ph: (269) 372-0961 |
NPI Number | 1831253996 |
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Provider Enumeration Date | 12/21/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1831253996 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC1900X | Psychologist - Counseling | 6301009393 (Michigan) | Primary |
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