Organization
LIDDERDALE CONSULTING PLC
Active
Other names
Melissa A. Lidderdale, PLC
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ANN LIDDERDALE PHD (PSYCHOLOGIST/OWNER)
(616) 426-9193
Entity
Organization
Contact information
Practice address
668 3 MILE RD NW STE D, GRAND RAPIDS, MI 49544-8219
(616) 426-9193
(616) 426-9455
Mailing address
57 COURTLAND ST UNIT 794, ROCKFORD, MI 49341-5027
(616) 426-9193
(616) 426-9455
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301012277
MI
103T00000X
Psychologist
Primary
6301014348
MI
103TC1900X
Counseling Psychologist
6301012277
MI
103TC1900X
Counseling Psychologist
6301014348
MI
Other
Enumeration date
03/30/2007
Last updated
05/24/2024
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