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1952907685
TARA HENDERSON
GRAND RAPIDS, MI
NPI
1952907685
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Former Name
TARA PUMMELL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801117772)
Enumeration Date
2020-12-08
Last Update Date
2024-06-27
Business Address
TARA HENDERSON
3300 36TH ST SE
GRAND RAPIDS, MI 49512-2810
Phone number: 616-942-2110
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Mailing Address
TARA HENDERSON
3300 36TH ST SE
GRAND RAPIDS, MI 49512-2810
Phone number: 616-942-2110
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