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Individual

SUSAN LESLEY KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
1601 GALBRAITH AVE SE, GRAND RAPIDS, MI 49546-6479
(616) 953-0544
Mailing address
1560 SEMINOLE RD SE, GRAND RAPIDS, MI 49506-6536
(949) 584-7554

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
35001905A
IN
106H00000X
Marriage & Family Therapist
Primary
4101006694
MI

Other

Enumeration date
10/21/2019
Last updated
01/04/2021
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