Individual
LARA DEWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, SCL
Contact information
Practice address
483 CENTURY LN, HOLLAND, MI 49423-4286
(616) 396-5284
Mailing address
483 CENTURY LN, HOLLAND, MI 49423-4286
(616) 355-7095
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YS0200X
School Counselor
SC0000001012118
MI
Other
Enumeration date
12/18/2019
Last updated
12/18/2019
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