Individual
GRACEANN MARY ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7150 KALAMAZOO AVE SE STE C, CALEDONIA, MI 49316-9197
(616) 219-0159
(616) 219-0124
Mailing address
7150 KALAMAZOO AVE SE STE C, CALEDONIA, MI 49316-9197
(616) 219-0159
(616) 219-0124
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301008866
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680D117560
BCBS
—
Enumeration date
07/31/2006
Last updated
03/19/2024
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