Individual
MRS. MARIAN EVELYN LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
40 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4304
(616) 356-6247
(616) 732-6392
Mailing address
809 E JUDD ST, GREENVILLE, MI 48838-2447
(616) 754-6085
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401008098
MI
Other
Enumeration date
11/28/2006
Last updated
07/09/2007
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