Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | L2440990 | MI |
N | 101YS0200X | School Counselor | SC000000080513 | MI |
NPI | 1144658048 |
---|---|
Provider Name | Cara Kuipers |
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 | 31/10/2013 |
Last Update Date | 31/10/2013 |