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Individual

MS. MARYANN RIGONI-SOUTHLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LLP, LLPC, NCC

Contact information

Practice address
3054 S 9TH ST, STE B, KALAMAZOO, MI 49009-6250
(269) 743-6139
Mailing address
PO BOX 2282, PORTAGE, MI 49081-2282
(269) 743-6139
(269) 290-7512

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401008766
MI
103TC1900X
Counseling Psychologist
6301011550
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
54949
NBCC #
01
6301011550
LLP LICENSE #
MI
01
6401008766
LLPC LICENSE #
MI
Enumeration date
01/17/2006
Last updated
12/20/2019
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