Healthcare Provider Details

I. General information

NPI: 1114369782
Provider Name (Legal Business Name): ASHLEY MICHELLE-SNEARY HANBERRY MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS ASHLEY MICHELLE RICE

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 E PARIS AVE SE 203
GRAND RAPIDS MI
49546-2426
US

IV. Provider business mailing address

2153 SANDY SHORE DR SE APT 101
KENTWOOD MI
49508-0954
US

V. Phone/Fax

Practice location:
  • Phone: 269-535-1536
  • Fax:
Mailing address:
  • Phone: 269-535-1536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401013749
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: