Individual
ALISON DAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 855-8958
Mailing address
790 FULLER AVE NE, GRAND RAPIDS MI, MI 49503
(616) 855-8958
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6801102792
MI
1041C0700X
Clinical Social Worker
Primary
6801107973
MI
Other
Enumeration date
01/22/2020
Last updated
02/02/2022
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