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Organization
LIFE GUIDANCE SERVIES
Active
Organization
LIFE GUIDANCE SERVIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA J EDWARDS (PRACTICE MANAGER)
(616) 954-1991
Entity
Organization
Contact information
Practice address
1400 LEONARD STREET NE, GRAND RAPIDS, MI 49505
(616) 954-1991
(616) 954-1998
Mailing address
1147 ARLINGTON NE, GRAND RAPIDS, MI 49505
(616) 954-1991
(616) 954-1998
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
681092605
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801092605
LICENSE
MI
Enumeration date
10/18/2010
Last updated
10/18/2010
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