Individual
KARIN MAYOGA VAN AST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLC
Contact information
Practice address
5360 CASCADE RD SE, GRAND RAPIDS, MI 49546-6404
(616) 217-9934
Mailing address
5360 CASCADE RD SE, GRAND RAPIDS, MI 49546-6404
(616) 217-9934
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6451023933
MI
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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