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General NPI Number Information
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NPI Number | 1245474691
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Entity Type | Individual
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Provider Name | ALISON PATRICIA MCCLURE MA, LLP
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Gender | Female
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 03/06/2020
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Provider Practice Location Address
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Address Line | 401 HALL ST SW STE 112J
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-6501
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Country | US
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Telephone | 616-426-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 2090 WALER DR
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City | HUDSONVILLE
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State | MI
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Zip | 49426-7430
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Country | US
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Telephone | 616-240-5947
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301015277
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License Number State | MI
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