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Organization
EDMEE PSYCHOLOGICAL SERVICES
Active
Organization
EDMEE PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY MARQUEE MA LLP (PSYCHOLOGIST/ADMINISTRATOR)
(616) 443-8968
Entity
Organization
Contact information
Practice address
2323 E PARIS AVE SE, SUITE 101, GRAND RAPIDS, MI 49546-2414
(616) 242-0099
(616) 242-0099
Mailing address
2323 E PARIS AVE SE, SUITE 101, GRAND RAPIDS, MI 49546-2414
(616) 242-0099
(616) 242-0099
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301013480
MI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
4301078556
MI
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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