Provider Demographics
NPI:1437336658
Name:LAMAN, MARK S (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:LAMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3124 N WELLNESS DR
Mailing Address - Street 2:SUITE 30
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-8121
Mailing Address - Country:US
Mailing Address - Phone:616-786-0500
Mailing Address - Fax:616-786-3375
Practice Address - Street 1:3124 N WELLNESS DR
Practice Address - Street 2:SUITE 30
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8121
Practice Address - Country:US
Practice Address - Phone:616-786-0500
Practice Address - Fax:616-786-3375
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6301006997103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0G04518OtherBLUECROSS/BLUESHIELD