Basic Information
| Provider Information | |||||||||
| NPI: | 1841574852 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LESTER | ||||||||
| FirstName: | DELIGHT | ||||||||
| MiddleName: | ANNETTE | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7216 11 MILE RD NE | ||||||||
| Address2: | |||||||||
| City: | ROCKFORD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 493419317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6164566135 | ||||||||
| FaxNumber: | 6167719762 | ||||||||
| Practice Location | |||||||||
| Address1: | 516 CHERRY ST SE | ||||||||
| Address2: | |||||||||
| City: | GRAND RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495034702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6164566135 | ||||||||
| FaxNumber: | 6167719762 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2011 | ||||||||
| LastUpdateDate: | 10/10/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 6801085018 | MI | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | 6801085018 | MI | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.