Individual
ELISABETH DAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
7086 8TH AVE, JENISON, MI 49428-9352
(616) 667-9551
Mailing address
2378 WOODLAKE DR STE 280, OKEMOS, MI 48864-6016
(517) 706-0421
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301015802
MI
Other
Enumeration date
09/09/2009
Last updated
01/04/2019
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