Individual
DIANA RAE SURRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6728 VINING RD, GREENVILLE, MI 48838-9784
(616) 225-8220
(616) 225-8226
Mailing address
PO BOX 1767, GRAND RAPIDS, MI 49501-1767
(616) 235-2090
(616) 235-2099
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801083023
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1715928
—
MI
Enumeration date
09/28/2006
Last updated
05/02/2017
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