Individual
JESSICA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-7294
Mailing address
2744 COLTON AVE SE, GRAND RAPIDS, MI 49506-4931
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401016540
MI
106H00000X
Marriage & Family Therapist
4101006786
MI
Other
Enumeration date
10/06/2018
Last updated
10/06/2018
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