| Miriam Lorrain Pllc | |
|
944 San Lucia Dr Se East Grand Rapids MI 49506-3455 | |
| (410) 802-0002 | |
| Not Available |
| Full Name | Miriam Lorrain Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 944 San Lucia Dr Se, East Grand Rapids, Michigan |
| Authorized Official Name and Position | Miriam Goldstein Lorrain (ORGANIZER) |
| Authorized Official Contact | 4108020002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miriam Lorrain Pllc 944 San Lucia Dr Se East Grand Rapids MI 49506-3455 Ph: () - | Miriam Lorrain Pllc 944 San Lucia Dr Se East Grand Rapids MI 49506-3455 Ph: (410) 802-0002 |
| NPI Number | 1134945215 |
|---|---|
| Provider Enumeration Date | 11/23/2024 |
| Last Update Date | 11/23/2024 |
| Certification Date | 11/23/2024 |
| Medicare PECOS PAC ID | 2365963659 |
|---|---|
| Medicare Enrollment ID | O20250303002149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134945215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Miriam Lorrain |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699238121 PECOS PAC ID: 5597121889 Enrollment ID: I20230511000381 |
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