Individual
KELLY ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 336-3909
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451024017
MI
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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