Individual
HEATHER K TRAVILLIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MLP
Contact information
Practice address
7150 KALAMAZOO AVE SE STE C, CALEDONIA, MI 49316-9197
(616) 622-3536
Mailing address
4821 E MEADOWS CT SE, GRAND RAPIDS, MI 49546-8248
(616) 622-3536
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6361008267
MI
Other
Enumeration date
11/05/2025
Last updated
11/05/2025
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