Provider Demographics
NPI:1518282631
Name:HOGETERP, MELANIE ANNE (MSW)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:ANNE
Last Name:HOGETERP
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 EAST PARIS SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512
Mailing Address - Country:US
Mailing Address - Phone:616-644-9024
Mailing Address - Fax:616-949-9115
Practice Address - Street 1:3180 EAST PARIS SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49512
Practice Address - Country:US
Practice Address - Phone:616-644-9024
Practice Address - Fax:616-949-9115
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010900781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical