NPI 1568003432

Justin Smyly

Practitioner Marriage & Family Therapist Holland, MI

Practice location

Address: 388 Garden Ave STE 110, Holland, MI 49424-8999
Phone: (616) 222-0631
Mailing address: 2551 Willow View Dr, Jenison, MI 49428-9284

Registered specialties

Marriage & Family Therapist Primary

Behavioral Health & Social Service Providers Taxonomy 106H00000X Licence 4101006893 (MI)

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Registry record

NPI: 1568003432
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Oct 2019
Record last updated: 2 Oct 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.