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General NPI Number Information
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NPI Number | 1689536575
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Entity Type | Organization
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Legal Business Name | GRIEFHAB
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Dates
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Enumeration Date | 11/29/2025
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Last Update Date | 11/29/2025
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Provider Practice Location Address
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Address Line | 77 MONROE CENTER ST NW STE 600
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2911
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Country | US
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Telephone | 231-707-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 3663 WREN DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49685-9716
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Country | US
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Telephone | 231-707-0706
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Fax |
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Authorized Official
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Title or Position | FOUNDER OWNER
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Name | MISS SAMANTHA RUTH
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Credential |
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Telephone | 231-707-0707
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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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