Organization
MICHIGAN STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RELANDA PRICE (LEAD ENROLLMENT COORDINATOR)
(517) 884-2976
Entity
Organization
Contact information
Practice address
909 WILSON RD RM B119, EAST LANSING, MI 48824-6410
(517) 353-3070
(517) 432-3603
Mailing address
804 SERVICE RD STE A109B, EAST LANSING, MI 48824-7015
(517) 353-3070
(517) 884-1817
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
MI
Other
Enumeration date
10/21/2016
Last updated
05/15/2023
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