Individual
HEATHER DUTHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, CAADC, CCS
Contact information
Practice address
2111 12 MILE RD NW, SPARTA, MI 49345-9754
(616) 391-8470
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6801086697
MI
101YP2500X
Professional Counselor
6801086697
MI
104100000X
Social Worker
Primary
6801086697
MI
Other
Enumeration date
03/03/2015
Last updated
06/26/2017
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