Provider Demographics
NPI:1841416096
Name:CURTIS, SANDRA RUTH (MSW)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:RUTH
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:RUTH
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2877 SUNSET RIDGE CT NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341
Mailing Address - Country:US
Mailing Address - Phone:616-866-1090
Mailing Address - Fax:
Practice Address - Street 1:1331 LAKE DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1674
Practice Address - Country:US
Practice Address - Phone:616-459-7215
Practice Address - Fax:616-235-0979
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010808691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical