Individual
MARYKAY RADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3285 S BROTON RD, FRUITPORT, MI 49415-9792
(231) 739-4359
(231) 733-6151
Mailing address
3285 S BROTON RD, FRUITPORT, MI 49415-9792
(231) 739-4359
(231) 733-6151
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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