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Individual

THERESA S DELACENSERIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1555 44TH ST SW, WYOMING, MI 49509-4313
(616) 888-3240
Mailing address
1555 44TH ST SW, WYOMING, MI 49509-4313
(616) 888-3240

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
147001192
IL
231H00000X
Audiologist
Primary
1601001097
MI

Other

Enumeration date
07/07/2006
Last updated
06/26/2024
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