Individual
EUGENE DIMENSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 970-0811
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 970-0811
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/03/2020
Last updated
09/12/2022
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