Individual
MRS. SUSAN DE WAARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LLP
Contact information
Practice address
201 SHELDON BLVD SE, GRAND RAPIDS, MI 49503-4513
(616) 459-4212
(616) 774-9022
Mailing address
201 SHELDON BLVD SE, GRAND RAPIDS, MI 49503-4513
(616) 459-4212
(616) 774-9022
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301002554
MI
103TB0200X
Cognitive & Behavioral Psychologist
6301002554
MI
103TC0700X
Clinical Psychologist
Primary
6301002554
MI
104100000X
Social Worker
—
MI
1041C0700X
Clinical Social Worker
6301002554
MI
Other
Enumeration date
11/21/2006
Last updated
09/11/2025
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