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Individual

MR. JOHN LAWRENCE TUTTLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, MED, LPC

Contact information

Practice address
8046 TEAKWOOD DR, JENISON, MI 49428-7766
(616) 826-3115
Mailing address
8046 TEAKWOOD DR, JENISON, MI 49428-7766
(616) 826-3115

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401012653
MI
101YP2500X
Professional Counselor
Primary
6401012653
MI

Other

Enumeration date
09/24/2011
Last updated
01/24/2018
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