Individual
STEFANIE HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
826 PARCHMENT DR SE STE 100, GRAND RAPIDS, MI 49546-2307
(616) 425-2224
Mailing address
2004 JANES AVE NE, GRAND RAPIDS, MI 49505-6227
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401016303
MI
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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