TRAVIS JOHN VANDERLIST

SAGINAW, MI
NPI1003155219
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: MI  6801090423)
Enumeration Date2013-02-07
Last Update Date2013-02-07
Business Address
MR. TRAVIS JOHN VANDERLIST LMSW
1500 WEISS ST
SAGINAW, MI 48602-5251
Phone number: 989-497-2500
Mailing Address
MR. TRAVIS JOHN VANDERLIST LMSW
311 OXFORD RD
EAST LANSING, MI 48823-2628
Phone number: 517-303-3969