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NPI Code Detail

MEDICARE: DIANA LYNN SPRINGSTEAD

MEDICARE:   DIANA LYNN SPRINGSTEAD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TR0400XRehabilitation Psychologist

General Provider Information

NPI Number : 1427576263
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA LYNN SPRINGSTEAD
Provider Business Mailing Address
First Line : PO BOW 674
Second Line :
City : MUSKEGON
State : MI
Zip : 49443
Country : US
Telephone Number : 231-343-8381
Fax Number :
Provider Business Practice Location Address
First Line : 1160 RANSOM ST
Second Line :
City : MUSKEGON
State : MI
Zip : 49442-3322
Country : US
Telephone Number : 231-343-8381
Fax Number : 231-343-8381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2017
Last Update Date : 12/28/2017

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Directions to “ DIANA LYNN SPRINGSTEAD ” Practice Location

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