Individual
MARK S KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD CSW
Contact information
Practice address
1015 PARCHMENT DRIVE SE, GRAND RAPIDS, MI 49546
(616) 464-0811
(616) 464-0812
Mailing address
1015 PARCHMENT DRIVE SE, GRAND RAPIDS, MI 49546
(616) 464-0811
(616) 464-0812
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301009094
MI
Other
Enumeration date
08/28/2006
Last updated
07/08/2007
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