Individual
CONNI RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
1352 TERRACE ST, MUSKEGON, MI 49442-3545
(231) 726-3582
(231) 722-6933
Mailing address
1352 TERRACE ST, MUSKEGON, MI 49442-3545
(231) 726-3582
(231) 722-6933
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301008671
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1883469
—
MI
01
—
P11126367
MULTIPLAN #
MI
Enumeration date
06/12/2006
Last updated
07/08/2007
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