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Individual

KATHY POLISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4255 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49508-3638
(616) 455-0960
(616) 455-7324
Mailing address
7428 MEDINAH DR, HUDSONVILLE, MI 49426-7561
(616) 455-0960
(616) 455-7324

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801058427
MI

Other

Enumeration date
02/26/2015
Last updated
02/26/2015
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