Organization
TOUCHSTONE INNOVARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SHANNON MARIE MULLETT LMSW (CLINICIAN)
(616) 459-0255
Entity
Organization
Contact information
Practice address
201 SHELDON BLVD SE, GRAND RAPIDS, MI 49503-4513
(616) 459-0255
(616) 242-6057
Mailing address
201 SHELDON BLVD SE, GRAND RAPIDS, MI 49503-4513
(616) 459-0255
(616) 242-6057
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
6801090829
MI
Other
Enumeration date
12/06/2010
Last updated
12/06/2010
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