Individual
CARLY WORMMEESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLBSW
Contact information
Practice address
713 N CENTER DR NW, WALKER, MI 49544-8215
(616) 784-1454
Mailing address
713 N CENTER DR NW, WALKER, MI 49544-8215
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6802090754
LARA
MI
Enumeration date
07/19/2018
Last updated
09/15/2020
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