Individual
KHAIRUN ROSHNEE HASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 BALL AVE NE, GRAND RAPIDS, MI 49505-5904
(616) 309-6931
Mailing address
1985 ELDON ST NE, GRAND RAPIDS, MI 49525-6133
(616) 309-6931
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
H250468744866
MI
Other
Enumeration date
10/02/2021
Last updated
10/02/2021
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