Individual
MR. THOMAS A HEROLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LMSW
Contact information
Practice address
1471 GRACE ST SE, GRAND RAPIDS, MI 49506-1678
(616) 913-2006
Mailing address
1471 GRACE ST SE, GRAND RAPIDS, MI 49506-1678
(616) 913-2006
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
6801064914
MI
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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