Provider Demographics
NPI:1083915276
Name:ALDERINK-HULST, SUSAN LEE (MA, LLP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LEE
Last Name:ALDERINK-HULST
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3178 68TH ST SE
Mailing Address - Street 2:SUITE C
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-7535
Mailing Address - Country:US
Mailing Address - Phone:616-803-0643
Mailing Address - Fax:
Practice Address - Street 1:3178 68TH ST SE
Practice Address - Street 2:SUITE C
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-7535
Practice Address - Country:US
Practice Address - Phone:616-803-0643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013813103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist