Individual
HEATHER L DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAFOADP
Contact information
Practice address
200 EASTERN AVE SE, GRAND RAPIDS, MI 49503-4735
(616) 776-0891
(616) 233-0687
Mailing address
330 EASTERN AVE SE, GRAND RAPIDS, MI 49503-4737
(616) 776-0891
(616) 233-0687
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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