Individual
MRS. LAURA JANE PITTSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLC, MT-BC, GC-C
Contact information
Practice address
2920 FULLER AVE NE STE 203, GRAND RAPIDS, MI 49505-3458
(217) 242-8165
Mailing address
1791 WATERBURY DR SE, KENTWOOD, MI 49508-6365
(217) 242-8165
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451023705
MI
Other
Enumeration date
09/21/2022
Last updated
07/13/2024
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