Lisa Marie Makuch, PHD

NPI #1548403439 in Portage, Michigan

Provider Information

NPI Number: 1548403439
Entity Type: Individual
Name: Lisa Marie Makuch, PHD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - Clinical
Credential: PHD
Enumeration Date: Apr 8, 2009
Last Updated: Apr 13, 2009

Practice Location

Address: 3770 GLENKERRY CT
City: Portage
State: Michigan
ZIP Code: 49024-0700
Phone: (269) 329-2887

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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