Individual
COLLEEN VANDOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5281 CLYDE PARK AVE SW, WYOMING, MI 49509-9506
(616) 719-4263
(616) 719-4267
Mailing address
5281 CLYDE PARK AVE SW, WYOMING, MI 49509-9506
(616) 719-4263
(616) 719-4267
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802087534
MI
Other
Enumeration date
02/11/2015
Last updated
02/11/2015
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