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General NPI Number Information
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NPI Number | 1073057360
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Entity Type | Individual
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Provider Name | MARIN HANN LPC
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Gender | Female
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Dates
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Enumeration Date | 12/06/2016
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 3500 BYRON CENTER AVE SW
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City | WYOMING
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State | MI
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Zip | 49519-3260
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Country | US
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Telephone | 616-208-9337
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 S CREEK DR SE APT 103
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City | KENTWOOD
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State | MI
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Zip | 49512-8334
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Country | US
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Telephone | 248-767-4637
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401015815
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License Number State | MI
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