Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 5201000343 | MI |
NPI | 1003174475 |
---|---|
Provider Name | Janis Feighner |
First Address | Grand Rapids, MI 49503-4526 |
Second Address | Grand Rapids, MI 49503-4526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 24/04/2012 |