Dr. Beth Joy Blackbird
Rehabilitation Psychologist
235 Wealthy St Se
Grand Rapids
, Michigan 49503-5299
Dr. Beth Joy Blackbird
Rehabilitation Psychologist
235 Wealthy St Se
Grand Rapids
, Michigan 49503-5299
(616) 242-9201
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About
Features
Specialties
- Rehabilitation Psychologist
Languages spoken
- English
Location
First Address
- Dr. Beth Joy Blackbird
- 235 Wealthy St Se
- Grand Rapids, MI
- Zip : 49503-5247
- Phone : (616) 242-9201
Second Address
- Dr. Beth Joy Blackbird
- 235 Wealthy St Se
- Grand Rapids, MI
- Zip : 49503-5299
- Fax : (616) 451-9513
- Phone : (616) 242-9201
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TR0400X | Rehabilitation Psychologist | 6301010300 | MI |
National Provider Identifier
| NPI | 1689631251 |
|---|---|
| Provider Name | Dr. Beth Joy Blackbird |
| First Address | Grand Rapids, MI 49503-5247 |
| Second Address | Grand Rapids, MI 49503-5299 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/04/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| BB010300 | PRIORITY HEALTH BLUE CROS (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.