Individual
AMANDA VERGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 N BUCHANAN ST, SPRING LAKE, MI 49456-1705
(586) 924-0125
Mailing address
521 MARION AVE, GRAND HAVEN, MI 49417-2104
(586) 924-0125
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401222869
MI
Other
Enumeration date
05/21/2018
Last updated
03/25/2024
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