Individual
NATHAN VISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2814 WOODCLIFF CIR SE, GRAND RAPIDS, MI 49506-3155
(855) 832-6727
Mailing address
2814 WOODCLIFF CIR SE, GRAND RAPIDS, MI 49506-3155
(309) 314-0489
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106S00000X
Behavior Technician
RBT-18-50912
MI
247200000X
Other Technician
—
—
Other
Enumeration date
06/03/2016
Last updated
04/17/2021
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