Individual
KHALIA RENITA TWORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
3501 LAKE EASTBROOK BLVD SE, SUITE 258, GRAND RAPIDS, MI 49546-5938
(616) 295-7614
Mailing address
3501 LAKE EASTBROOK BLVD SE, SUITE 258, GRAND RAPIDS, MI 49546-5938
(616) 295-7614
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401013477
MI
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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