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General NPI Number Information
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NPI Number | 1932923596
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Entity Type | Organization
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Legal Business Name | HOLLAND PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 250 MONROE AVE NW # 2511
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2211
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Country | US
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Telephone | 313-424-9995
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Fax |
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Provider Business Mailing Address
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Address Line | 6143 MADISON ST
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City | COLOMA
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State | MI
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Zip | 49038-9335
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Country | US
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Telephone | 313-424-9995
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | LAWRENCE MICHAEL KALB
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Credential | PH.D.
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Telephone | 313-424-9995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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