Individual
BREEYN NICOLE MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, CAADC
Contact information
Practice address
1971 E BELTLINE AVE NE STE 106, GRAND RAPIDS, MI 49525-7045
(616) 666-6904
Mailing address
1538 TAMARACK AVE NW, GRAND RAPIDS, MI 49504-3041
(810) 334-0506
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6301015970
MI
Other
Enumeration date
08/06/2015
Last updated
03/19/2024
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