Individual
DR. ELIZABETH RAESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 831-5649
(616) 942-9548
Mailing address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 831-5649
(616) 942-9548
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301014727
MI
Other
Enumeration date
09/05/2007
Last updated
04/18/2014
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