Individual
MARY LYNN VANDRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.,CCC-A
Contact information
Practice address
705 W. LAKE LANSING ROAD, EAST LANSING, MI 48823
(517) 337-2411
(517) 337-6033
Mailing address
PO BOX 406153, ATLANTA, GA 30384-1876
(810) 177-1385
(810) 733-7893
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000092
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174568422
—
MI
Enumeration date
06/19/2006
Last updated
01/16/2009
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