Individual
DANIELLE BOUDIAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1549 CHAPEL RD, MUSKEGON, MI 49441-3754
(989) 996-0371
Mailing address
76 UNION AVE SE APT 201, GRAND RAPIDS, MI 49503-4452
(989) 996-0371
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
18036150231
MI
163W00000X
Registered Nurse
Primary
4704329894
MI
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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