Individual
MRS. BRENDA SUE VANDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A
Contact information
Practice address
2786 56TH ST, TENDERCARE WYOMING, WYOMING, MI 49418
(616) 261-3960
(616) 261-3925
Mailing address
1875 108TH ST SW, BYRON CENTER, MI 49315
(616) 308-8736
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202006468
MI
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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