Individual
DR. STEVEN RENZE DE GROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
2015 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49507-4003
(616) 243-4686
Mailing address
2015 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49507-4003
(616) 243-4686
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301011991
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68-OD003550
BLUE CROSS
MI
Enumeration date
02/01/2007
Last updated
07/08/2007
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