Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1164988754 |
---|---|
Provider Name | Arianna Tolsma |
First Address | Grand Rapids, MI 49512-2810 |
Second Address | Grand Rapids, MI 49512-2810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2019 |
Last Update Date | 19/02/2019 |