Individual
MARY RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 DIANA ST, LUDINGTON, MI 49431-1987
(231) 845-6294
(231) 845-7095
Mailing address
920 DIANA ST, LUDINGTON, MI 49431-1987
(231) 845-6294
(231) 845-7095
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401016428
MI
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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