| Doctor Name: | MRS. MELISSA LYNN VANDER KOOI |
| NPI Number: | 1629224001 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | TLPC, TLLP |
| License Number: | 6401007890 |
| Business Practice Address: | 1019 Parchment Dr Se Grand Rapids, MI - 495463664 |
| Business Phone Number: | 6162858868 |
| Business Fax Number: | 6162858875 |
| Mailing Address: | 7400 Emerald Woods Dr Se, BYRON CENTER |
| State: | MI |
| Postal Code: | 493158977 |
| Phone Number: | 6166986980 |
| Fax Number: | |
| NPI Enumeration Date: | 08/17/2008 |
| NPI Last Update Date: | 08/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 6401007890 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |