Individual
CRAIG ROBERT VANDER MAAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
4100 LAKE DR SE, SUITE 305, GRAND RAPIDS, MI 47546
(616) 285-1377
(616) 285-1006
Mailing address
61 COMMERCE AVE SW, GRAND RAPIDS, MI 49503-4124
(616) 940-0660
(616) 940-1965
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401003522
MI
103TC0700X
Clinical Psychologist
Primary
6301011634
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044021
VALUE OPTIONS
—
01
—
680D146850
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/19/2006
Last updated
11/19/2008
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