Individual
BRIAN LYNN GRIPENTROG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
5301 ADA DR SE, ADA, MI 49301-7831
(616) 706-3666
Mailing address
5301 ADA DR SE, ADA, MI 49301-7831
(616) 706-3666
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801089592
MI
Other
Enumeration date
11/25/2020
Last updated
11/25/2020
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