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Individual

PETER J CAPPON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
30 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4304
(616) 303-1313
Mailing address
3413 TOMAHAWK DR SW, GRANDVILLE, MI 49418-1961
(616) 202-8240

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401016700
MI
101YP2500X
Professional Counselor
Primary
6401018523
MI

Other

Enumeration date
06/25/2018
Last updated
10/11/2024
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