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General NPI Number Information
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NPI Number | 1518610104
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Entity Type | Individual
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Provider Name | HOLLI-NOELLE DUECK LLPC
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Gender | Female
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 02/02/2022
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Provider Practice Location Address
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Address Line | 4867 EAST BELTLINE AVE NE BUILDING #1
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-4952
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Country | US
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Telephone | 616-813-6013
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 BURTON ST SE # TAU01
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-4301
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Country | US
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Telephone | 616-813-6013
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6451020901
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License Number State | MI
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