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Organization
APX PSYCHOLOGICAL PC
Active
Organization
APX PSYCHOLOGICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAUREN KAVANAUGH-WALLACE PSYD (PRESIDENT)
(810) 664-8060
Entity
Organization
Contact information
Practice address
700 S MAIN ST, SUITE 208, LAPEER, MI 48446-3077
(810) 664-8060
(810) 245-8352
Mailing address
PO BOX 985, LAPEER, MI 48446-0985
(810) 664-8060
(810) 245-8352
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160412
VALUE OPTIONS
—
Enumeration date
08/08/2006
Last updated
08/22/2020
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