Individual
DR. MELISSA ANN LIDDERDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1345 MONROE AVE NW STE 252, GRAND RAPIDS, MI 49505-4612
(616) 426-9193
Mailing address
57 COURTLAND ST UNIT 794, ROCKFORD, MI 49341-5027
(616) 426-9193
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301014348
MI
103TC0700X
Clinical Psychologist
Primary
6301014348
MI
103TC1900X
Counseling Psychologist
6301014348
MI
Other
Enumeration date
03/30/2007
Last updated
12/02/2025
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