Individual
ELISE MACKENZIE RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 BALL AVE NE, GRAND RAPIDS, MI 49505-5904
(616) 456-6571
Mailing address
1127 52ND AVE, APT. C7, ALLENDALE, MI 49401-5904
(517) 993-4217
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
MI
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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