Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003227851 |
---|---|
Provider Name | Ariana Berrios |
First Address | Grand Rapids, MI 49534-1295 |
Second Address | Grand Rapids, MI 49534-1295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2014 |
Last Update Date | 14/05/2014 |