Individual
MARIANNE GOERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
8435 HOLLY RD, GRAND BLANC, MI 48439-1812
(810) 424-2400
(810) 579-7222
Mailing address
3495 S CENTER RD, BURTON, MI 48519-1455
(810) 424-2011
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1606356
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007186
MCLAREN HEALTH ADVANTAGE
MI
01
—
1007251
MCLAREN HEALTH PLAN PIN
MI
01
—
348-776-000
MAGELLAN PIN
MI
01
—
68-0-F3-3300-0
BLUE CROSS PIN
MI
Enumeration date
02/09/2007
Last updated
02/10/2014
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