Organization
LISA LAMANCUSA MA, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA LAMANCUSA LIMITED LICENSED PSY (BUSINESS OWNER)
(616) 364-3301
Entity
Organization
Contact information
Practice address
4829 E BELTLINE AVE NE STE 100, GRAND RAPIDS, MI 49525-9349
(616) 364-3301
Mailing address
4829 E BELTLINE AVE NE STE 100, GRAND RAPIDS, MI 49525-9349
(616) 364-3301
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301012462
MI
Other
Enumeration date
04/26/2018
Last updated
04/26/2018
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