Individual
MRS. BRENDA JOY HAAKSMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
2032 S CROSS CREEK DR SE, GRAND RAPIDS, MI 49508-8780
(616) 745-8308
Mailing address
2032 S CROSS CREEK DR SE STE 1, GRAND RAPIDS, MI 49508-8780
(616) 745-8308
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01109430
MI
235Z00000X
Speech-Language Pathologist
SLP.0000730
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99556502
—
CO
Enumeration date
04/10/2007
Last updated
02/16/2023
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