Individual
MRS. TERRI IRENE WOOD BRUININKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4200 W MICHIGAN AVE STE 60, KALAMAZOO, MI 49006-5895
(269) 377-7863
Mailing address
5805 OAKLAND DR, PORTAGE, MI 49024-1118
(269) 323-4180
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6801089579
MI
Other
Enumeration date
07/10/2008
Last updated
06/11/2009
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