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Individual

MR. JONATHAN ATHEARN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
TLLP

Contact information

Practice address
1331 LAKE DR SE, GRAND RAPIDS, MI 49506-1674
(616) 459-7215
(616) 235-0979
Mailing address
4229 HOMESTEAD, WAYLAND, MI 49348-8975

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301013388
MI

Other

Enumeration date
04/19/2007
Last updated
07/08/2007
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