Individual
KEVIN DANIEL VAILLANCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLPC
Contact information
Practice address
15495 OLD MILLPOND RD, BIG RAPIDS, MI 49307-9502
(231) 796-9188
Mailing address
1004 S ANNA ST, MT PLEASANT, MI 48858-3602
(989) 944-3589
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401015505
MI
Other
Enumeration date
07/17/2016
Last updated
07/17/2016
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