Organization
ADOLESCENT AND FAMILY BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VALENCIA AGNEW PHD (PSYCHOLOGIST)
(616) 719-0194
Entity
Organization
Contact information
Practice address
3501 LAKE EASTBROOK BLVD SE, #258, GRAND RAPIDS, MI 49546-5938
(616) 719-0194
(800) 219-5205
Mailing address
2566 WOODMEADOW DR SE, GRAND RAPIDS, MI 49546-8031
(616) 719-0194
(800) 219-5205
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301015520
MI
Other
Enumeration date
11/20/2013
Last updated
02/09/2019
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