Individual
KELLI VAN DER HEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4670 FULTON ST E STE 201, ADA, MI 49301-8409
(616) 591-2905
Mailing address
4670 FULTON ST E STE 201, ADA, MI 49301-8409
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101004541
MI
Other
Enumeration date
10/21/2014
Last updated
09/15/2025
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