Individual
MR. TIMOTHY CHARLES ROSENBOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. DIV.
Contact information
Practice address
960 E STATE ST, CASSOPOLIS, MI 49031-9339
(269) 476-9781
(269) 476-9783
Mailing address
8848 KEPHART LN, BERRIEN SPRINGS, MI 49103-1440
(269) 471-1955
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
140001
MI
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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