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General NPI Number Information
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NPI Number | 1811291990
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Entity Type | Organization
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Legal Business Name | ALPHA PSYCHOLOGICAL SERVICES OF WESTERN MICHIGAN
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 03/25/2011
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Provider Practice Location Address
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Address Line | 1804 OAK AVE
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City | MUSKEGON
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State | MI
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Zip | 49442-2408
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Country | US
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Telephone | 231-773-8093
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Fax | 231-773-8952
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Provider Business Mailing Address
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Address Line | 1804 OAK AVE
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City | MUSKEGON
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State | MI
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Zip | 49442-2408
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Country | US
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Telephone | 231-773-8093
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Fax | 231-773-8952
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. ALLAN WARREN CRUMMETT
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Credential | ED.D.
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Telephone | 231-773-8093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 6301006533
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License Number State | MI
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