Most Relevant Information
Provider Data
| NPI Number: | 1003486150 |
| Provider Name: | BRIANNE ILYSE ROUX LLPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 6401019441 |
Most Important Dates
| Enumeration Date: | 06/30/2021 |
| Last Updated: | 06/30/2021 |
Provider Practice Location
11335 JAMES ST
HOLLAND
MI
494248627
Practice Location Phone/Fax
| Phone: | 6163960623 |
| Fax: |
Provider Mailing Location
117 E 37TH ST
HOLLAND
MI
494237068
Provider Mailing Phone/Fax
| Phone: | 6166101697 |
| Fax: |