Individual
TERRY WITHERSPOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1750 E GRAND RIVER AVE STE 101, EAST LANSING, MI 48823-4958
(269) 213-9426
Mailing address
2811 SOUTHWOOD DR, EAST LANSING, MI 48823-2346
(269) 213-9426
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401013063
MI
Other
Enumeration date
09/24/2014
Last updated
08/30/2023
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