Individual
DAVID E THORNSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
500 CASCADE WEST PKWY SE STE 240, GRAND RAPIDS, MI 49546-2166
(616) 591-9000
(616) 591-9004
Mailing address
500 CASCADE WEST PKWY SE STE 240, GRAND RAPIDS, MI 49546-2166
(616) 591-9000
(616) 591-9004
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301012067
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680D114760
BCBS OF MICHIGAN
MI
Enumeration date
04/04/2006
Last updated
04/23/2021
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