Healthcare Provider Details

I. General information

NPI: 1376936971
Provider Name (Legal Business Name): ALLISON ROSINSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON HAAN

II. Dates (important events)

Enumeration Date: 03/06/2015
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 FULLER AVE NE
GRAND RAPIDS MI
49503-1918
US

IV. Provider business mailing address

2503 WOODLAKE RD SW APT 6
WYOMING MI
49519-4710
US

V. Phone/Fax

Practice location:
  • Phone: 616-855-5138
  • Fax:
Mailing address:
  • Phone: 708-334-3128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801093716
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: