Individual
MR. TRAVIS VANOOSTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
711 LOGAN ST SE, GRAND RAPIDS, MI 49503-5528
(616) 516-7152
Mailing address
711 LOGAN ST SE, GRAND RAPIDS, MI 49503-5528
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-15-01121
MI
Other
Enumeration date
03/17/2016
Last updated
03/17/2016
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