Healthcare Provider Details

I. General information

NPI: 1043943848
Provider Name (Legal Business Name): EM SAUER PSYCHOLOGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4484 ASHFORD DR NE
GRAND RAPIDS MI
49525-9408
US

IV. Provider business mailing address

4484 ASHFORD DR NE
GRAND RAPIDS MI
49525-9408
US

V. Phone/Fax

Practice location:
  • Phone: 616-822-1185
  • Fax:
Mailing address:
  • Phone: 616-822-1185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ERIC SAUER
Title or Position: OWNER
Credential:
Phone: 616-622-1185