Basic Information
| Provider Information | |||||||||
| NPI: | 1881923761 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALLEN | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | MA LLP CAAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1883 HOLLOW CREEK DR SE | ||||||||
| Address2: | |||||||||
| City: | CALEDONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 493167805 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 201 SHELDON BLVD SE | ||||||||
| Address2: | |||||||||
| City: | GRAND RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495034513 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6164590255 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/23/2009 | ||||||||
| LastUpdateDate: | 12/23/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC1900X | 6301013828 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No ID Information.