Individual
DR. BETH JOY BLACKBIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5299
(616) 242-9201
(616) 451-9513
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8668
(616) 840-9762
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
6301010300
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BB010300
PRIORITY HEALTH BLUE CROS
—
Enumeration date
04/27/2006
Last updated
03/08/2024
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