Provider Demographics
NPI:1992839591
Name:DEVELOPMENTAL ENHANCEMENT
Entity Type:Organization
Organization Name:DEVELOPMENTAL ENHANCEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:616-534-4953
Mailing Address - Street 1:854 WASHINGTON AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-7141
Mailing Address - Country:US
Mailing Address - Phone:616-499-2218
Mailing Address - Fax:616-499-2219
Practice Address - Street 1:854 WASHINGTON AVE STE 600
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7141
Practice Address - Country:US
Practice Address - Phone:616-499-2218
Practice Address - Fax:616-499-2219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011127103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty