Doctor Name: | SUSAN LENORE RICHARDS |
NPI Number: | 1174874242 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 6801092571 |
Business Practice Address: | 375 Apple Tree Dr Ionia, MI - 488467506 |
Business Phone Number: | 6165271790 |
Business Fax Number: | 6165270538 |
Mailing Address: | 375 Apple Tree Dr, IONIA |
State: | MI |
Postal Code: | 488467506 |
Phone Number: | 6165271790 |
Fax Number: | 6165270538 |
NPI Enumeration Date: | 09/28/2012 |
NPI Last Update Date: | 03/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801092571 |
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 |