Organization
BRAVE GRAND RAPIDS LLC
Active
Other names
Brave GR
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALLISON KYLE WALDRON LLPC (MANAGER)
(616) 419-8628
Entity
Organization
Contact information
Practice address
103 COLLEGE AVE SE, GRAND RAPIDS, MI 49503-5921
(616) 419-8628
Mailing address
103 COLLEGE AVE SE, GRAND RAPIDS, MI 49503-5921
(616) 419-8628
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401015446
MI
Other
Enumeration date
07/06/2016
Last updated
10/05/2016
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