Robertson, Graceann Mary

Robertson, Graceann Mary is an sole proprietor health care provider with primary practice located at 7150 Kalamazoo Ave Se Ste C , Caledonia MI 49316-9197. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Robertson, Graceann Mary can be contacted via phone (616) 219-0159.

Contact Information

Primary practice address
7150 Kalamazoo Ave Se Ste C Caledonia MI 49316-9197
Phone: (616) 219-0159
Fax: (616) 219-0124
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6301008866 Michigan

Profile Details

NPI number 1063428134
LBN Legal business name Robertson, Graceann Mary
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2006
Last updated Mar 19th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063428134 NPPES
Other 680D117560 BCBS

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