Provider Demographics
NPI:1629440979
Name:FIRLAN, URMINDA SUE (PHD, DLLP)
Entity Type:Individual
Prefix:DR
First Name:URMINDA
Middle Name:SUE
Last Name:FIRLAN
Suffix:
Gender:F
Credentials:PHD, DLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3795 HILTON AVE SE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331-9527
Mailing Address - Country:US
Mailing Address - Phone:616-901-9507
Mailing Address - Fax:
Practice Address - Street 1:3795 HILTON AVE SE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331-9527
Practice Address - Country:US
Practice Address - Phone:616-901-9507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016514103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist