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General NPI Number Information
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NPI Number | 1720990484
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Entity Type | Individual
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Provider Name | MRS. MADELYN HEERES
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Gender | Female
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 3909 BALDWIN ST
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City | HUDSONVILLE
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State | MI
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Zip | 49426-7376
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Country | US
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Telephone | 616-797-9797
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Fax | 616-797-9929
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Provider Business Mailing Address
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Address Line | 4103 PORT SHELDON ST
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City | HUDSONVILLE
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State | MI
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Zip | 49426-8900
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Country | US
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Telephone | 616-669-1740
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Fax |
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 6851119783
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License Number State | MI
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