Provider Demographics
NPI:1275921538
Name:LEMMON, RONALD
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:LEMMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 PINEHURST BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458-1024
Mailing Address - Country:US
Mailing Address - Phone:810-686-5739
Mailing Address - Fax:
Practice Address - Street 1:2700 ROBERT T LONGWAY BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2190
Practice Address - Country:US
Practice Address - Phone:810-496-4955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker