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General NPI Number Information
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NPI Number | 1477019404
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Entity Type | Organization
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Legal Business Name | MELISSA MUIR COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 630 KENMOOR AVE SE STE 101A
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-8626
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Country | US
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Telephone | 616-446-8436
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Fax | 616-920-6536
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Provider Business Mailing Address
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Address Line | 630 KENMOOR AVE SE STE 101A
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-8626
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Country | US
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Telephone | 616-446-8436
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Fax | 616-920-6536
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA MUIR
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Credential |
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Telephone | 616-446-8436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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