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Organization
MIND BODY SOULUTIONS, LLC
Active
Organization
MIND BODY SOULUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANYSSA GRENDEL LMSW (LICENSED MASTERS SOCIAL WORKER)
(616) 240-4685
Entity
Organization
Contact information
Practice address
5242 PLAINFIELD AVE NE, GRAND RAPIDS, MI 49525-1084
(616) 613-6130
Mailing address
5242 PLAINFIELD AVE NE, GRAND RAPIDS, MI 49525-1084
(616) 613-6130
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801096853
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598157612
TYPE 1 INDIVIDUAL NPI NUMBER
—
Enumeration date
10/22/2016
Last updated
03/07/2024
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