Individual
KIMBERLY NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 855-5226
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 855-5226
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
68065
MI
Other
Enumeration date
04/01/2020
Last updated
03/03/2022
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