PATIENT KATABANA BARAKA

WYOMING, MI
NPI1366889313
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: MI  6801093577)
Enumeration Date2013-05-31
Last Update Date2013-05-31
Business Address
-- PATIENT KATABANA BARAKA LLMSW
255 COLRAIN ST SW
WYOMING, MI 49548-1013
Phone number: 616-988-1479
Mailing Address
-- PATIENT KATABANA BARAKA LLMSW
79 ANTOINE ST SW
GRAND RAPIDS, MI 49507-1001
Phone number: 616-988-1479
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