Individual
TIMOTHY ADLI KANAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
816 E MICHIGAN AVE STE 103, PAW PAW, MI 49079
(269) 501-5829
Mailing address
49324 CHURCHILL ST, MATTAWAN, MI 49071-8910
(269) 501-5829
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401012892
MI
Other
Enumeration date
04/28/2017
Last updated
06/08/2024
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