Individual
DR. LISA KIMBERLY LARGO-MARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
8799 GULL ROAD, SUITE 1, RICHLAND, MI 49083
(269) 629-2207
(269) 731-2324
Mailing address
8799 GULL RD, SUITE 1, RICHLAND, MI 49083-9100
(269) 629-2207
(269) 629-2207
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301008181
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114812
VALUE OPTIONS
MI
01
—
1148122
VALUE OPTIONS
MI
01
—
21170586108
BEECH STREET CORPORATION
MI
01
—
680C960810
BCBS OF MICHIGAN
MI
Enumeration date
09/13/2005
Last updated
08/01/2010
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