Provider Demographics
NPI:1871831321
Name:HUIZINGA, HOPE RUANA (LMSW)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:RUANA
Last Name:HUIZINGA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:HOPE
Other - Middle Name:RUANA
Other - Last Name:BUQUET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 RAYBROOK ST SE STE 203
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-5783
Mailing Address - Country:US
Mailing Address - Phone:616-956-9440
Mailing Address - Fax:616-954-1520
Practice Address - Street 1:2100 RAYBROOK ST SE STE 203
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-5783
Practice Address - Country:US
Practice Address - Phone:616-956-9440
Practice Address - Fax:616-954-1520
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
MI68010892321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker