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General NPI Number Information
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NPI Number | 1982906871
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Entity Type | Organization
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Legal Business Name | THERESA ANDERSON-VARNEY P.C.
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Dates
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Enumeration Date | 11/26/2010
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Last Update Date | 11/26/2010
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Provider Practice Location Address
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Address Line | 1019 PARCHMENT DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-3664
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Country | US
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Telephone | 616-285-8868
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Fax | 616-285-8875
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Provider Business Mailing Address
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Address Line | 1019 PARCHMENT DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-3664
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Country | US
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Telephone | 616-285-8868
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Fax | 616-285-8875
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THERESA ANDERSON-VARNEY
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Credential | PHD
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Telephone | 616-285-8868
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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 | MI
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