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Organization

MICHAEL MAKEDONSKY PHD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL M MAKEDONSKY PHD (OWNER)
(616) 957-0731
Entity
Organization

Contact information

Practice address
3501 LAKE EASTBROOK BLVD SE STE 222, GRAND RAPIDS, MI 49546-5940
(616) 957-0731
Mailing address
PO BOX 120125, GRAND RAPIDS, MI 49528-0103
(616) 235-2090
(616) 235-2099

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
04/03/2008
Last updated
04/03/2008
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