Individual
JUSTIN SMYLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
388 GARDEN AVE STE 110, HOLLAND, MI 49424-8999
(616) 222-0631
Mailing address
2551 WILLOW VIEW DR, JENISON, MI 49428-9284
(248) 877-4492
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4101006893
MI
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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