Individual
BEN BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, TLLP
Contact information
Practice address
321 FULTON ST, GRAND HAVEN, MI 49417-1231
(616) 842-4772
(616) 842-5575
Mailing address
321 FULTON ST, GRAND HAVEN, MI 49417-1231
(616) 842-4772
(616) 842-5575
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301013254
MI
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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