Provider Demographics
NPI:1992831358
Name:CANTU PLEWS, DEENA IRIS (LIMITED LICENSED PSY)
Entity Type:Individual
Prefix:MS
First Name:DEENA
Middle Name:IRIS
Last Name:CANTU PLEWS
Suffix:
Gender:F
Credentials:LIMITED LICENSED PSY
Other - Prefix:MS
Other - First Name:DEENA
Other - Middle Name:IRIS
Other - Last Name:PLEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLP
Mailing Address - Street 1:16 N MONROE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341
Mailing Address - Country:US
Mailing Address - Phone:616-866-4830
Mailing Address - Fax:616-866-4744
Practice Address - Street 1:16 N MONROE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341
Practice Address - Country:US
Practice Address - Phone:616-866-4830
Practice Address - Fax:616-866-4744
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007463103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical