Individual
MS. LISA JEAN RATHBUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.S.W., A.C.S.W.
Contact information
Practice address
4477 CASCADE RD SE, GRAND RAPIDS, MI 49546-3632
(616) 726-6437
(616) 957-1438
Mailing address
3130 HOEHN ST N.W., GRAND RAPIDS, MI 49504-2488
(616) 726-6437
(616) 957-1438
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6801078044
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801078044
S.W. REGISTRATION
MI
Enumeration date
12/06/2006
Last updated
07/08/2007
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