Doctor Name: | MRS. SARAH MARIE DEVISSER |
NPI Number: | 1053681643 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 6801091439 |
Business Practice Address: | 16760 Lincoln St Grand Haven, MI - 494178864 |
Business Phone Number: | 6163658920 |
Business Fax Number: | 6163658971 |
Mailing Address: | 3351 Eagle Run Dr Ne, Ste C GRAND RAPIDS |
State: | MI |
Postal Code: | 495257070 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/12/2012 |
NPI Last Update Date: | 02/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801091439 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |