Youngblood-Field, Tierra

Youngblood-Field, Tierra is an sole proprietor health care provider with primary practice located at 790 Fuller Ave Ne , Grand Rapids MI 49503-1918. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Youngblood-Field, Tierra can be contacted via phone (616) 336-3909.

Contact Information

Primary practice address
790 Fuller Ave Ne Grand Rapids MI 49503-1918
Phone: (616) 336-3909
Fax: (616) 336-8830
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4101006746 Michigan
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4101007120 Michigan
Behavioral Health & Social Service Providers / Professional 101YP2500X 6401017826 Michigan

Profile Details

NPI number 1346757762
LBN Legal business name Youngblood-Field, Tierra
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 8th, 2018
Last updated May 15th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1346757762 NPPES
Michigan MEDICAID 1346757762

Popular Providers