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Individual

MRS. AMANDA LEE WILLEMIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
PO BOX 392, TRAVERSE CITY, MI 49685-0392
(231) 268-0007
(231) 525-3170
Mailing address
1635 GREEN OAKS DR, INTERLOCHEN, MI 49643-9186
(989) 330-8943

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
12/06/2024
Last updated
12/06/2024
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