Individual
LAWRENCE DONTA YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
410 60TH ST SE, KENTWOOD, MI 49548-6810
(616) 685-0828
Mailing address
410 60TH ST SE, KENTWOOD, MI 49548-6810
(616) 685-0828
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401019225
MI
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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