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Individual

COLIN THOMAS MOYLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1115 BALL AVE NE, GRAND RAPIDS, MI 49505-5904
(616) 456-6571
Mailing address
311 MORRISON ST APT 14, BIG RAPIDS, MI 49307-2223
(989) 578-2976

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary

Other

Enumeration date
09/22/2020
Last updated
09/22/2020
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