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General NPI Number Information
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NPI Number | 1306996467
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Entity Type | Individual
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Provider Name | DEBORAH DENISE SPOORS MA
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1514 WEALTHY ST SE SUITE 260
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-2755
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Country | US
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Telephone | 616-451-3008
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Fax | 616-451-3070
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Provider Business Mailing Address
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Address Line | 8342 HIAWATHA DR
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City | WEST OLIVE
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State | MI
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Zip | 49460-9511
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Country | US
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Telephone | 616-638-4671
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Fax | 616-451-3070
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301007767
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License Number State | MI
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