| Doctor Name: | STEPHANIE WITTEVEEN |
| NPI Number: | 1104285303 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPC |
| License Number: | 6401013655 |
| Business Practice Address: | 300 S State St Ste 13 Zeeland, MI - 494641676 |
| Business Phone Number: | 6167721733 |
| Business Fax Number: | |
| Mailing Address: | 10427 Northfield Dr, ZEELAND |
| State: | MI |
| Postal Code: | 494646846 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/16/2016 |
| NPI Last Update Date: | 02/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401013655 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |