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Individual

DR. PAUL CRITELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
858 IROQUOIS DR SE, GRAND RAPIDS, MI 49506-3373
(616) 248-4738
(616) 248-4745
Mailing address
858 IROQUOIS DR SE, GRAND RAPIDS, MI 49506-3373
(616) 248-4738
(616) 248-4745

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301002801
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041872
VALUEOPTIONS
MI
01
4590519
AETNA
MI
01
68OC445030
BLUE CROSS BLUE SHIELD
MI
01
7419464
CIGNA BEHAVIORAL HEALTH
MI
Enumeration date
06/27/2006
Last updated
07/08/2007
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