Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801094244 | MI |
NPI | 1003170978 |
---|---|
Provider Name | Sarah Stryd |
First Address | Holland, MI 49424-1230 |
Second Address | Holland, MI 49424-9661 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 24/10/2017 |