Individual
DEBRA L VANDENBOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAPCC LPC
Contact information
Practice address
80 ELKENBURG ST, SOUTH HAVEN, MI 49090-1275
(269) 205-3502
Mailing address
2900 CLEVELAND AVE APT 212, SAINT JOSEPH, MI 49085-2364
(262) 325-7424
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401224288
MI
101YM0800X
Mental Health Counselor
6451020862
MI
Other
Enumeration date
10/06/2022
Last updated
06/25/2024
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