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Individual

MRS. KATHERINE BANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1651 E NICKERSON AVE, BENTON HARBOR, MI 49022-2469
(269) 983-5833
Mailing address
2801 VALLEYDALE DR NW APT 201, WALKER, MI 49534-2600
(513) 325-8598

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010043
MI

Other

Enumeration date
07/31/2018
Last updated
10/25/2019
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