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General NPI Number Information
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NPI Number | 1083760326
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Entity Type | Individual
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Provider Name | JOHN ALEXANDER BELLINGHAM JR. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1801 E SAGINAW ST SUITE H
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City | LANSING
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State | MI
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Zip | 48912-2326
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Country | US
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Telephone | 517-482-4090
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Fax |
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Provider Business Mailing Address
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Address Line | 8358 S LOOMIS RD
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City | DEWITT
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State | MI
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Zip | 48820-9752
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Country | US
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Telephone | 517-669-8008
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6301005594
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License Number State | MI
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