Individual
THOMAS LEE IPPEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2020 RAYBROOK ST SE, SUITE 203, GRAND RAPIDS, MI 49546-7717
(616) 942-9942
Mailing address
2020 RAYBROOK ST SE, SUITE 203, GRAND RAPIDS, MI 49546-7717
(616) 942-9942
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301003264
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68OD145630
BC BS OF MICHIGAN PIN
MI
Enumeration date
02/01/2007
Last updated
06/15/2011
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