Individual
MS. D'ESTINAY NOWACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
630 KENMOOR AVE SE STE 101B, GRAND RAPIDS, MI 49546-8626
(616) 379-0496
Mailing address
630 KENMOOR AVE SE STE 101B, GRAND RAPIDS, MI 49546-8626
(616) 379-0496
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801099498
MI
1041C0700X
Clinical Social Worker
Primary
6801104054
MI
Other
Enumeration date
11/18/2016
Last updated
11/04/2024
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