Most Relevant Information
Provider Data
| NPI Number: | 1003800889 |
| Provider Name: | DIANA LYNN SPRING MALLP |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: | 6361004181 |
Most Important Dates
| Enumeration Date: | 09/07/2005 |
| Last Updated: | 08/07/2022 |
Provider Practice Location
2127 UNIVERSITY PARK DR STE 300
OKEMOS
MI
488645928
Practice Location Phone/Fax
| Phone: | 5177053667 |
| Fax: | 2486053525 |
Provider Mailing Location
PO BOX 772263
DETROIT
MI
482770428
Provider Mailing Phone/Fax
| Phone: | 9894944613 |
| Fax: | 2486053525 |