Individual
KAYLA VANDENBOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
9948 CENTER ST, REESE, MI 48757-9547
(989) 297-0042
Mailing address
9948 CENTER ST, REESE, MI 48757-9547
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
59652
MI
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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