| Kara Pettinger, L.l.c. | |
|
630 Kenmoor Ave Se Ste 103 Grand Rapids MI 49546-8626 | |
| (517) 983-3384 | |
| Not Available |
| Full Name | Kara Pettinger, L.l.c. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 630 Kenmoor Ave Se Ste 103, Grand Rapids, Michigan |
| Authorized Official Name and Position | Kara M Pettinger (OWNER/THERAPIST) |
| Authorized Official Contact | 5179833384 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kara Pettinger, L.l.c. 5741 Dorado Ct Ne Rockford MI 49341-8335 Ph: (517) 983-3384 | Kara Pettinger, L.l.c. 630 Kenmoor Ave Se Ste 103 Grand Rapids MI 49546-8626 Ph: (517) 983-3384 |
| NPI Number | 1780394460 |
|---|---|
| Provider Enumeration Date | 12/02/2022 |
| Last Update Date | 12/02/2022 |
| Certification Date | 12/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780394460 | NPI | - | NPPES |
| 1689086654 | Other | MI | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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