Individual
MELISSA ANN AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110
Mailing address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC0005477
GA
101YP2500X
Professional Counselor
Primary
6401223565
MI
103K00000X
Behavior Analyst
LPC0005477
GA
Other
Enumeration date
03/15/2010
Last updated
08/03/2023
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