Individual
MRS. CLARA M. AQUINO-MASCORRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DM, CAC-II,LBSW
Contact information
Practice address
412 CENTURY LN, HOLLAND, MI 49423-4285
(616) 396-2301
(616) 396-8070
Mailing address
3048 OLD ALLEGAN RD, FENNVILLE, MI 49408-9495
(269) 561-4845
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2-00839
MI
104100000X
Social Worker
6802079603
MI
Other
Enumeration date
03/30/2007
Last updated
01/09/2013
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