Most Relevant Information
Provider Data
| NPI Number: | 1003250242 |
| Provider Name: | MARILYN DALE LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 6401000980 |
Most Important Dates
| Enumeration Date: | 04/18/2013 |
| Last Updated: | 04/28/2020 |
Provider Practice Location
5005 PLAINFIELD AVE NE STE 100
GRAND RAPIDS
MI
49525
Practice Location Phone/Fax
| Phone: | 6162793869 |
| Fax: | 6166084657 |
Provider Mailing Location
5005 PLAINFIELD AVE NE STE 100
GRAND RAPIDS
MI
49525
Provider Mailing Phone/Fax
| Phone: | 6162793869 |
| Fax: | 6166084657 |