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Mary Mildred Van Bonn, MA, LLPC

Counselor, Professional in Grand Haven, MI. Individual provider (NPI-1).

NPI number1982170262
StatusActive
Last updated in NPPESOct 15, 2018

Details

NPI
1982170262
Entity type
Individual (NPI-1)
Name
Mary Mildred Van Bonn
Credential
MA, LLPC
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 15, 2018
Last updated
Oct 15, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional6401016842MIYes

Practice location

512 Washington Ave Ste B
Grand Haven, MI 49417-1455

Phone 616-209-9577

Mailing address

549 Colfax Ave
Grand Haven, MI 49417-1828

Phone 616-209-9577

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