Individual
MARK E DEVRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Mailing address
1055 ROSALIE AVE NW, GRAND RAPIDS, MI 49504-3720
(616) 581-1969
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301008596
MI
103T00000X
Psychologist
6301008596
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680D161890
BC/BS
MI
Enumeration date
06/16/2006
Last updated
02/23/2026
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