Individual
ELIZABETH VANWOERKOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 336-3909
(616) 336-8830
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 336-3909
(616) 336-8830
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
455049055
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487035879
NPI
MI
Enumeration date
01/07/2019
Last updated
04/02/2024
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