Individual
KEVIN GREG MAYBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLPC
Contact information
Practice address
5020 E BELTLINE AVE NE, SUITE 202, GRAND RAPIDS, MI 49525
(616) 439-1866
Mailing address
5020 E BELTLINE AVE NE, SUITE 202, GRAND RAPIDS, MI 49525
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401019425
MI
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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