Healthcare Provider Details

I. General information

NPI: 1467550301
Provider Name (Legal Business Name): PATRICIA J DEUR LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 E APPLE AVENUE
MUSKEGON MI
49442
US

IV. Provider business mailing address

3347 W RIVER
MUSKEGON MI
49445
US

V. Phone/Fax

Practice location:
  • Phone: 231-724-1111
  • Fax: 231-724-3659
Mailing address:
  • Phone: 231-744-2641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801033910
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: