Individual
LISA LAVERELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
216 CYPRESS AVE, HOLLAND, MI 49423-3835
(616) 392-5642
Mailing address
216 CYPRESS AVE, HOLLAND, MI 49423-3835
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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