Organization
BEHAVIORAL MEDICINE ASSOCIATES OF MID MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNN ELAINE SIMONS PSY.D. (DIRECTOR)
(989) 832-9161
Entity
Organization
Contact information
Practice address
1205 E WACKERLY ST, MIDLAND, MI 48642-7035
(989) 832-9161
(989) 832-8813
Mailing address
1205 E WACKERLY ST, MIDLAND, MI 48642-7035
(989) 832-9161
(989) 832-8813
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P36530
MEDICARE PTAN
—
Enumeration date
10/16/2006
Last updated
12/04/2014
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