Organization
MADRID PSYCHOLOGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAUL P. MADRID PSY. D. (CHIEF ASSOCIATE/PRESIDENT)
(616) 534-5445
Entity
Organization
Contact information
Practice address
4467 BYRON CENTER AVE SW, WYOMING, MI 49519-4808
(616) 534-5445
(616) 534-5536
Mailing address
4467 BYRON CENTER AVE SW, WYOMING, MI 49519-4808
(616) 534-5445
(616) 534-5536
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301007493
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D14683
BLUE CROSS BLUE SHIELD
MI
Enumeration date
03/04/2008
Last updated
07/10/2008
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