Individual
MR. TIMOTHY LEWIS RADABAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LLP
Contact information
Practice address
742 LUDINGTON AVE, PORTAGE, MI 49002-7804
(269) 876-0228
Mailing address
742 LUDINGTON AVE, PORTAGE, MI 49002-7804
(269) 876-0228
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361004740
MI
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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