Individual
HEATHER JANE DANNISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LP, LPC
Contact information
Practice address
4029 W MAIN ST, KALAMAZOO, MI 49006-2763
(269) 692-5321
(269) 312-7328
Mailing address
604 S ROSE ST, KALAMAZOO, MI 49007-5273
(517) 256-8476
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401014264
MI
103TC1900X
Counseling Psychologist
Primary
6301016125
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679985873
NPI 1
MI
Enumeration date
05/22/2014
Last updated
04/23/2019
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