Individual
CAROL VANDELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
3000 MONROE AVE NE, GRAND RAPIDS, MI 49505-3397
(616) 364-5295
(616) 365-3804
Mailing address
3000 MONROE AVE NE, GRAND RAPIDS, MI 49505-3397
(616) 364-5295
(616) 365-3804
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801001317
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CV001317
BCBS OF MICHIGAN
MI
Enumeration date
07/11/2006
Last updated
07/08/2007
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