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Individual

DR. RANDALL LEE HERREMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
3501 LAKE EASTBROOK BLVD SE, SUITE 280, GRAND RAPIDS, MI 49546-5938
(616) 942-7331
Mailing address
3501 LAKE EASTBROOK BLVD SE, SUITE 280, GRAND RAPIDS, MI 49546
(616) 942-7331

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301003721
MI

Other

Enumeration date
01/04/2007
Last updated
07/08/2007
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