Individual
AMANDA LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., MLP
Contact information
Practice address
1514 WEALTHY ST SE STE 256, GRAND RAPIDS, MI 49506-2755
(616) 780-1284
(616) 427-1624
Mailing address
1514 WEALTHY ST SE STE 256, GRAND RAPIDS, MI 49506-2755
(616) 780-1284
(616) 427-1624
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301015820
MI
Other
Enumeration date
03/13/2014
Last updated
12/28/2022
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