Individual
AMANDA SYVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
101YP2500X
Professional Counselor
0000003057
TN
101YP2500X
Professional Counselor
Primary
6401014031
MI
Other
Enumeration date
02/13/2014
Last updated
02/13/2014
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