Healthcare Provider Details

I. General information

NPI: 1811037567
Provider Name (Legal Business Name): ALETTA E VANDERPLAAT M.A, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 08/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 3 MILE RD NW STE 1
GRAND RAPIDS MI
49544-8220
US

IV. Provider business mailing address

700 3 MILE RD NW STE 1
GRAND RAPIDS MI
49544-8220
US

V. Phone/Fax

Practice location:
  • Phone: 616-785-2769
  • Fax:
Mailing address:
  • Phone: 616-785-2769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401000155
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: