Individual
VICKY LYNN ARNOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5313 RUGBY ST, PORTAGE, MI 49024-5538
(269) 381-9527
Mailing address
5313 RUGBY ST, PORTAGE, MI 49024-5538
(269) 381-9527
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AF390238306
MI
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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