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Individual

MICHELE MARIE VANDER BEEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
5659 STADIUM DR, KALAMAZOO, MI 49009-1932
(269) 372-0436
Mailing address
605 HOWARD ST, KALAMAZOO, MI 49008-1919

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5201010196
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5201010196
STATE OF MICHIGAN
MI
Enumeration date
04/10/2018
Last updated
06/29/2021
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