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Individual

DIANA VICTORINO-TELLEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
669 STOCKING AVE NW, GRAND RAPIDS, MI 49504-5176
(231) 260-5361
Mailing address
669 STOCKING AVE NW, GRAND RAPIDS, MI 49504-5176
(616) 258-9287

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MI

Other

Enumeration date
03/08/2024
Last updated
10/13/2025
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