Individual
SAMANTHA DOORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 60TH ST SE STE B, KENTWOOD, MI 49508-7065
(616) 466-4137
Mailing address
1401 60TH ST SE STE B, KENTWOOD, MI 49508-7065
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6451023813
MI
101YP2500X
Professional Counselor
Primary
6451023813
MI
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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