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Organization
INTENTIONAL LIFE COUNSELING & ADDICTIONS TREATMENT PLLC
Active
Organization
INTENTIONAL LIFE COUNSELING & ADDICTIONS TREATMENT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAVONE HUINIL MSW (OWNER)
(616) 734-9745
Entity
Organization
Contact information
Practice address
1444 MICHIGAN ST NE STE 3, GRAND RAPIDS, MI 49503-2028
(616) 734-9745
Mailing address
1444 MICHIGAN ST NE STE 3, GRAND RAPIDS, MI 49503-2028
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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