Individual
STACEY MICHELLE VANDENBERGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2922 FULLER AVE NE STE 105, GRAND RAPIDS, MI 49505-3459
(616) 327-6191
(616) 333-4928
Mailing address
2922 FULLER AVE NE STE 105, GRAND RAPIDS, MI 49505-3459
(616) 327-6191
(616) 333-4928
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201012832
MI
Other
Enumeration date
02/09/2022
Last updated
01/28/2026
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