Individual
DRAYCEN DECATOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3292 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 365-8920
(616) 365-8971
Mailing address
3292 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 365-8920
(616) 365-8971
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301017537
MI
Other
Enumeration date
07/28/2018
Last updated
07/28/2018
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