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Patient Katabana Baraka, LLMSW
Mental Health Counselor in Wyoming, Michigan
NPI 1366889313

Patient Katabana Baraka is a Mental Health Counselor based in Grand Rapids, MI and is specialized in Mental Health. Patient Katabana Baraka practices in Wyoming, MI and has the professional credentials of LLMSW. The NPI Number for Patient Katabana Baraka is 1366889313 and holds a License No. 6801093577 (Michigan).

The current practice location address for Patient Katabana Baraka is 255 Colrain St Sw, Wyoming, MI and can be reached out via phone at 616-988-1479 and via fax at 616-245-0450.

Location: 255 Colrain St Sw, Wyoming, MI, 49507-1001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366889313
Provider Name
Patient Katabana Baraka
Credential
LLMSW
Provider Entity Type
Individual
Gender
Male
Address
255 Colrain St Sw, Wyoming, MI, 49507-1001
Phone Number
616-988-1479
Fax Number
616-245-0450
Provider Enumeration Date
05/31/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
255 Colrain St Sw
City
Wyoming
State
Michigan
Zip
49548-1013
Phone Number
616-988-1479
Fax Number
616-245-0450
person
Provider Business Mailing Address Details
Address
255 Colrain St Sw
City
Wyoming
State
Michigan
Zip
49548-1013
Phone Number
616-988-1479
Fax Number
616-245-0450
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
6801093577 (Michigan)
Definition
Definition to come...
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