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Individual

MR. JUAN FRANCISCO CARISALEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LLP

Contact information

Practice address
1530 NICHOLS RD, KALAMAZOO, MI 49006-2065
(269) 343-6700
(269) 343-4831
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
(616) 455-5960

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
MI
103T00000X
Psychologist
Primary
6361000011
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1883502
MI
Enumeration date
10/26/2009
Last updated
05/11/2021
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