Individual
ARDEAN BETH BROCK-VANDERWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.DIV., M.A.
Contact information
Practice address
2828 KRAFT AVE., GRAND RAPIDS, MI 49512
(616) 949-9550
(616) 949-9551
Mailing address
3208 WOODBERRY DRIVE, GRAND RAPIDS, MI 49512
(616) 893-6420
(616) 891-9676
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401011131
MI
Other
Enumeration date
07/20/2009
Last updated
10/26/2015
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