MEDICARE: MARY LAFRAMBOISE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1366854283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY LAFRAMBOISE

Provider Business Mailing Address
First Line	:	21833 CUTLER ROAD
Second Line	:
City	:	STANTON
State	:	MI
Zip	:	48888-9702
Country	:	US
Telephone Number	:	616-240-6250
Fax Number	:

Provider Business Practice Location Address
First Line	:	1971 E BELTLINE AVE NE STE A
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49525-7045
Country	:	US
Telephone Number	:	616-439-1135
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2014
Last Update Date	:	07/21/2022

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Directions to “ MARY LAFRAMBOISE ” Practice Location

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