Provider Demographics
NPI:1437789120
Name:PRZYBYSZ, ANN LOUISE (CTRS, BS, QIDP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:LOUISE
Last Name:PRZYBYSZ
Suffix:
Gender:F
Credentials:CTRS, BS, QIDP
Other - Prefix:MISS
Other - First Name:ANN
Other - Middle Name:LOUISE
Other - Last Name:SMIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CTRS
Mailing Address - Street 1:3310 EAGLE PARK DR NE STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-4574
Mailing Address - Country:US
Mailing Address - Phone:616-825-5850
Mailing Address - Fax:616-655-1784
Practice Address - Street 1:3310 EAGLE PARK DR NE STE 100
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-4574
Practice Address - Country:US
Practice Address - Phone:616-825-5850
Practice Address - Fax:616-655-1784
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist