Individual
LISA ANN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, CBIS
Contact information
Practice address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 464-0275
(616) 940-8151
Mailing address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 464-0275
(616) 940-8151
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1528043544
MI
Other
Enumeration date
03/25/2009
Last updated
03/25/2009
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