Individual
LISA TAMBLYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5242 PLAINFIELD AVE NE STE C, GRAND RAPIDS, MI 49525-1084
(616) 318-6394
Mailing address
5242 PLAINFIELD AVE NE STE C, GRAND RAPIDS, MI 49525-1084
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401013914
MI
Other
Enumeration date
03/07/2014
Last updated
12/18/2018
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