Provider Demographics
NPI:1639746811
Name:SYBESMA, ANDREA (BSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:SYBESMA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4387 INDIAN SPRING DR SW
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49418-1763
Mailing Address - Country:US
Mailing Address - Phone:616-502-2073
Mailing Address - Fax:
Practice Address - Street 1:4387 INDIAN SPRING DR SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418-1763
Practice Address - Country:US
Practice Address - Phone:616-502-2073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker