Individual
MRS. CAROLE ANN SISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
906 LAKE MICHIGAN DR. NW, GRAND RAPIDS, MI 49504
(616) 808-1898
Mailing address
906 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49504-5643
(616) 808-1898
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6401006497
MI
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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