Organization
ADHDONLINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA DAVISSON (BILLER/CODER)
(517) 740-0184
Entity
Organization
Contact information
Practice address
5619 BALSAM DR, HUDSONVILLE, MI 49426-1128
(616) 229-2935
Mailing address
5619 BALSAM DR, HUDSONVILLE, MI 49426-1128
(616) 229-2935
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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