Individual
MRS. KACEY ANN VANDERPOOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLBSW
Contact information
Practice address
3111 ELECTRIC AVE, PORT HURON, MI 48060-8127
(810) 985-8900
Mailing address
3111 ELECTRIC AVE, PORT HURON, MI 48060-8127
(810) 985-8900
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6852089695
MI
Other
Enumeration date
08/21/2017
Last updated
08/05/2021
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