| Richland Psychology, Pllc | |
|
9037 E D Ave Richland MI 49083-9454 | |
| (269) 629-2207 | |
| (269) 731-2881 |
| Full Name | Richland Psychology, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 9037 E D Ave, Richland, Michigan |
| Authorized Official Name and Position | Lisa Kimberly Largo-marsh (LICENSED PSYCHOLOGIST/MEMBER OWNER) |
| Authorized Official Contact | 2696292207 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richland Psychology, Pllc 9037 E D Ave Po Box 253 Richland MI 49083-9454 Ph: (269) 629-2207 | Richland Psychology, Pllc 9037 E D Ave Richland MI 49083-9454 Ph: (269) 629-2207 |
| NPI Number | 1760872568 |
|---|---|
| Provider Enumeration Date | 01/31/2015 |
| Last Update Date | 11/02/2015 |
| Medicare PECOS PAC ID | 8325348055 |
|---|---|
| Medicare Enrollment ID | O20151201002332 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760872568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301008181 (Michigan) | Primary |
| Provider Name | Lisa K Largo Marsh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023003340 PECOS PAC ID: 5799675138 Enrollment ID: I20040318000677 |
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