Individual
DR. NICHOLAS RUBEN DEBERNARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
1836 BALDWIN ST, JENISON, MI 49428-8901
(616) 457-0016
(616) 457-1950
Mailing address
1836 BALDWIN ST, JENISON, MI 49428-8901
(616) 457-0016
(616) 457-1950
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015230
MI
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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