Individual
MRS. HENRIETTA NMN SQUIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, OTR
Contact information
Practice address
781 36TH ST SE, GRAND RAPIDS, MI 49548-2319
(616) 248-5112
(616) 243-2302
Mailing address
781 36TH ST SE, GRAND RAPIDS, MI 49548-2319
(616) 248-5112
(616) 243-2302
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802058948
MI
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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