MEDICARE: CINDY L. HANER-VELZEN MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801083017	MI

General Provider Information

NPI Number	:	1396927182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY L. HANER-VELZEN MSW

Provider Business Mailing Address
First Line	:	600 3 MILE RD NW
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49544-1685
Country	:	US
Telephone Number	:	616-647-3460
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 3 MILE RD NW
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49544-1685
Country	:	US
Telephone Number	:	616-647-3460
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2007
Last Update Date	:	12/04/2007

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