Individual
MS. DIANE H. BORNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGIST
Contact information
Practice address
3299 GULL RD., 1ST W 3RD FL, NAZARETH, MI 49074-0063
(269) 553-8060
(269) 553-8104
Mailing address
84 S LAKE DOSTER DR, PLAINWELL, MI 49080-9109
(269) 664-3066
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301008718
MI
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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