Individual
MELISTA DEE GENZINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
516 CHERRY ST SE, GRAND RAPIDS, MI 49503-4702
(616) 456-6135
(616) 771-9779
Mailing address
516 CHERRY ST SE, GRAND RAPIDS, MI 49503-4702
(616) 456-6135
(616) 771-9779
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
6801091836
MI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/01/2013
Last updated
02/01/2013
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