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Organization
TARA DEROO LLC
Active
Organization
TARA DEROO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA DEROO LMSW (SOCIAL WORKER)
(616) 264-3200
Entity
Organization
Contact information
Practice address
4127 EMBASSY DR SE, GRAND RAPIDS, MI 49546-2418
(616) 264-3200
(616) 264-3201
Mailing address
4127 EMBASSY DR SE, GRAND RAPIDS, MI 49546-2418
(616) 264-3200
(616) 264-3201
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801081584
MI
Other
Enumeration date
03/07/2013
Last updated
03/07/2013
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