Individual
KYLE BOASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
6963 MARSHALL AVE SE, GRAND RAPIDS, MI 49508-7438
(616) 207-4655
Mailing address
6963 MARSHALL AVE SE, GRAND RAPIDS, MI 49508-7438
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401018677
MI
Other
Enumeration date
03/15/2021
Last updated
03/15/2021
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