Individual
LISA YOUNGMAN-LOOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
700 HAMMOND RD E, TRAVERSE CITY, MI 49686-8641
(231) 947-2255
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401017908
MI
247200000X
Other Technician
—
—
Other
Enumeration date
02/16/2016
Last updated
11/25/2024
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