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Mark B Mahacek, PSYD

Psychologist in Spring Lake, MI. Individual provider (NPI-1).

NPI number1346330438
StatusActive
Last updated in NPPESOct 5, 2023

Details

NPI
1346330438
Entity type
Individual (NPI-1)
Name
Mark B Mahacek
Credential
PSYD
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 13, 2006
Certification date
Oct 5, 2023
Last updated
Oct 5, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103T00000X PsychologistMM008350MIYes

Practice location

19100 N Fruitport Rd
Spring Lake, MI 49456-1165

Phone 616-842-2125

Mailing address

19100 N Fruitport Rd
Spring Lake, MI 49456-1165

Phone 616-842-2125

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