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NPI 1083595888

NPI 1083595888 : LUKE TANNER RASPER : HUDSONVILLE, MI

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General NPI Number Information
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    NPI Number           |    1083595888
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    Entity Type          |    Individual 
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    Provider Name        |    LUKE TANNER RASPER
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/09/2025
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    Last Update Date     |    09/09/2025
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Provider Practice Location Address
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    Address Line         |    3424 CHICAGO DR STE 205 
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    City                 |    HUDSONVILLE
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    State                |    MI
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    Zip                  |    49426-1411
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    Country              |    US
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    Telephone            |    616-426-9034
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6148 BLENDON DR APT 204 
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    City                 |    HUDSONVILLE
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    State                |    MI
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    Zip                  |    49426-8050
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    Country              |    US
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    Telephone            |    616-426-9034
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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