Individual
LYDIA CM BOONZAAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2019 RAMBLING RD, KALAMAZOO, MI 49008-1630
(213) 807-0882
Mailing address
3667 S 9TH ST, KALAMAZOO, MI 49009-9502
(213) 807-0882
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6451022584
MI
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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