Individual
LAURA DANIELLE MAMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LMFT, NCC, ACS
Contact information
Practice address
805 LEONARD ST NE, GRAND RAPIDS, MI 49503-1138
(616) 774-4617
(616) 361-4141
Mailing address
805 LEONARD ST NE, GRAND RAPIDS, MI 49503-1138
(616) 774-4617
(616) 361-4141
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401007999
MI
106H00000X
Marriage & Family Therapist
4101006214
MI
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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