MEDICARE: ASHLEY K DEVOS L.L.M.S.W.

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	6801089990	MI

General Provider Information

NPI Number	:	1790963304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY K DEVOS L.L.M.S.W.

Provider Business Mailing Address
First Line	:	4050 RECTOR AVE NE
Second Line	:
City	:	ROCKFORD
State	:	MI
Zip	:	49341-9144
Country	:	US
Telephone Number	:	616-863-6848
Fax Number	:

Provider Business Practice Location Address
First Line	:	3351 36TH ST SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49512-2809
Country	:	US
Telephone Number	:	616-942-7294
Fax Number	:	616-942-9548

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

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	02/06/2008

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Directions to “ ASHLEY K DEVOS L.L.M.S.W.” Practice Location

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