Individual
TAMARA L THELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D., CCC-A
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-2862
Mailing address
4880 CASCADE RD SE, GRAND RAPIDS, MI 49546-3721
(616) 954-9300
(616) 954-9543
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000244
MI
Other
Enumeration date
04/03/2007
Last updated
04/26/2016
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