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General NPI Number Information
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NPI Number | 1104380518
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Entity Type | Organization
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Legal Business Name | JULIANNE LETTINGA, MA LPC COUNSELING
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Dates
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Enumeration Date | 01/30/2019
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | 3280 EAST BELTLINE CT NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525
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Country | US
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Telephone | 616-644-3962
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Fax |
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Provider Business Mailing Address
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Address Line | 3280 EAST BELTLINE CT NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525
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Country | US
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Telephone | 616-644-3962
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | MRS. JULIANNE LETTINGA
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Credential | MA, LPC
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Telephone | 616-644-3962
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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 |
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License Number State |
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