Individual
LEANN MCAULIFFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
640 3 MILE RD NW STE G, GRAND RAPIDS, MI 49544-8209
(586) 204-6417
Mailing address
7125 HEADLEY ST. SE #733, ADA, MI 49301
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361004856
MI
Other
Enumeration date
05/07/2021
Last updated
06/23/2021
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