| Doctor Name: | MR. ROBERT TERRY EKKENS |
| NPI Number: | 1831348143 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MALMSW |
| License Number: | 6401001743 |
| Business Practice Address: | 1049 E Newell St White Cloud, MI - 493498795 |
| Business Phone Number: | 2316897330 |
| Business Fax Number: | |
| Mailing Address: | 1505 Sandy Point Ave Se, GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495469725 |
| Phone Number: | 6166762713 |
| Fax Number: | |
| NPI Enumeration Date: | 09/10/2008 |
| NPI Last Update Date: | 09/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401001743 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |