Individual
SARA RUTH LYNEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5270
(616) 455-5460
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301014465
MI
103T00000X
Psychologist
Primary
6301014932
MI
Other
Enumeration date
06/04/2010
Last updated
05/14/2014
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