Healthcare Provider Details
I. General information
NPI: 1639888910
Provider Name (Legal Business Name): A MOTHER'S TOUCH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
856 DICKINSON ST SE
GRAND RAPIDS MI
49507-2043
US
IV. Provider business mailing address
PO BOX 7873
GRAND RAPIDS MI
49510-7873
US
V. Phone/Fax
- Phone: 616-514-0547
- Fax:
- Phone: 616-514-0547
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
CRYSTAL
BARNETT
Title or Position: FOUNDER, EXECUTIVE DIRECTOR
Credential: LLMSW, CPRM
Phone: 616-259-0461