Individual
MRS. JOHANNA KATHLEEN DENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
654 DAVIS AVE NW, GRAND RAPIDS, MI 49504-5149
(616) 897-7842
Mailing address
11650 DOWNES ST NE, LOWELL, MI 49331-9489
(616) 897-7842
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4101006804
MI
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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