NPI | 1871613968 |
---|---|
Former Legal Business Name | MELISSA A. LIDDERDALE, PLC |
Entity Type | Organization |
Authorized Contact | MELISSA ANN LIDDERDALE Psychologist/Owner 616-426-9193 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301014348) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301012277) |
103TC1900X Psychologist, Counseling (Licence: MI 6301012277) | |
103TC1900X Psychologist, Counseling (Licence: MI 6301014348) | |
Enumeration Date | 2007-03-30 |
Last Update Date | 2024-05-24 |