Provider Demographics
NPI:1548785702
Name:MARY LAFRAMBOISE
Entity Type:Organization
Organization Name:MARY LAFRAMBOISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFRAMBOISE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-439-1135
Mailing Address - Street 1:21833 CUTLER RD
Mailing Address - Street 2:
Mailing Address - City:HOWARD CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49329-9307
Mailing Address - Country:US
Mailing Address - Phone:616-240-6250
Mailing Address - Fax:
Practice Address - Street 1:1971 E BELTLINE AVE NE STE A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7045
Practice Address - Country:US
Practice Address - Phone:616-439-1135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty