Individual provider · Type 1 NPI

Dominique Phua

Addiction (Substance Use Disorder) Counselor · Grand Rapids, MI

NPI number 1053784413 Active

Practice location

1115 Ball Ave NE
Grand Rapids, MI 49505-5904

Call (616) 459-7215 Map

Mailing address

3249 Huntington Woods Dr SE, Apt F
Kentwood, MI 49512-8128

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X3743369 (MI)

Addiction (Substance Use Disorder) Counselor: Definition to come...

344 other providers at this address

Other addiction (substance use disorder) counselor providers in Grand Rapids

See all in Grand Rapids →

About NPI 1053784413

Dominique Phua's National Provider Identifier is 1053784413, issued on Nov 7, 2015. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Grand Rapids, MI. The record was last updated on Nov 7, 2015.