Individual
ALLISON MARIE DEGOEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
755 36TH ST SE, GRAND RAPIDS, MI 49548-2319
(616) 301-8000
Mailing address
2601 WOODLAKE RD SW APT 4, WYOMING, MI 49519-4603
(616) 204-3189
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801091488
MI
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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