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Individual

MRS. CATHERINE M LISENBEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.,CCC-A

Contact information

Practice address
751 KENMOOR AVE SE, SUITE B, GRAND RAPIDS, MI 49546-2391
(616) 954-1895
(616) 954-2093
Mailing address
P.O. BOX 406153, ATLANTA, GA 30384-1876
(616) 954-1895

Taxonomy

Speciality
Code
Description
License number
State
231HA2400X
Assistive Technology Practitioner Audiologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
903336569
MI
Enumeration date
06/08/2006
Last updated
04/14/2009
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