NPI | 1467873414 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANE FENNEMA Mange Care Administrator 616-281-6372 |
Organization Subpart ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
Additional Taxonomies | 225X00000X Occupational Therapist |
Enumeration Date | 2013-12-18 |
Last Update Date | 2025-09-23 |