Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6801096461 | MI |
NPI | 1003318924 |
---|---|
Provider Name | Delanie Grace Vanpelt-Cousins |
First Address | Kalamazoo, MI 49007-5221 |
Second Address | Kalamazoo, MI 49007-5221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2018 |
Last Update Date | 07/03/2018 |