Provider Demographics
NPI:1609086172
Name:ROSANDER, TERRY ANN (PHD, MSW, BS)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ANN
Last Name:ROSANDER
Suffix:
Gender:F
Credentials:PHD, MSW, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 PARCHMENT DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3664
Mailing Address - Country:US
Mailing Address - Phone:616-285-7027
Mailing Address - Fax:
Practice Address - Street 1:1007 PARCHMENT DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3664
Practice Address - Country:US
Practice Address - Phone:616-285-7027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist