Individual
VALENCIA LENAA AGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3501 LAKE EASTBROOK BLVD SE, SUITE 258, GRAND RAPIDS, MI 49546-5938
(616) 719-0194
(800) 219-5205
Mailing address
3501 LAKE EASTBROOK BLVD SE, SUITE 258, GRAND RAPIDS, MI 49546-5938
(616) 719-0194
(800) 219-5205
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301011046
MI
103T00000X
Psychologist
6301015520
MI
Other
Enumeration date
10/19/2006
Last updated
01/15/2014
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