Individual
DR. MY THI LIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4701 PLAINFIELD AVE NE, SUITE C, GRAND RAPIDS, MI 49525-1644
(616) 361-3365
(616) 361-3395
Mailing address
4701 PLAINFIELD AVE NE, SUITE C, GRAND RAPIDS, MI 49525-1644
(616) 361-3365
(616) 361-3395
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301013608
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301013608
MI
103TH0004X
Health Psychologist
6301013608
MI
103TM1800X
Intellectual & Developmental Disabilities Psychologist
6301013608
MI
103TS0200X
School Psychologist
6301013608
MI
Other
Enumeration date
02/09/2008
Last updated
04/03/2009
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