Organization
GREAT LAKES WELLNESS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN HANSEN LPC (OWNER)
(616) 202-1910
Entity
Organization
Contact information
Practice address
2900 WILSON AVE SUITE 110, GRANDVILLE, MI 49418
(616) 202-1910
(616) 383-9600
Mailing address
2900 WILSON AVE SUITE 110, GRANDVILLE, MI 49418
(616) 202-1910
(616) 383-9600
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012367
MI
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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