Individual
ELLIANNE KIMES MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 KENMOOR AVE SE STE 110, GRAND RAPIDS, MI 49546-2379
(616) 591-2905
(616) 333-2321
Mailing address
710 KENMOOR AVE SE STE 110, GRAND RAPIDS, MI 49546-2379
(616) 591-2905
(616) 333-2321
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7152000343
MI
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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