Individual
AIJA LUBAVS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
5930 LOVERS LN, PORTAGE, MI 49002-1673
(269) 353-4370
(269) 344-8696
Mailing address
2116 ABERDEEN DR, KALAMAZOO, MI 49008-1728
(269) 343-3353
(269) 344-8696
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301008381
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P10893971
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/19/2006
Last updated
01/20/2011
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