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1538790910
KRISTINE ELIZABETH GERVASI
BENTON HARBOR, MI
NPI
1538790910
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2020-02-04
Last Update Date
2020-02-04
Business Address
KRISTINE ELIZABETH GERVASI QIDP
1613 M 139
BENTON HARBOR, MI 49022-5748
Phone number: 269-925-0585
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Mailing Address
KRISTINE ELIZABETH GERVASI QIDP
1485 M 139
BENTON HARBOR, MI 49022-5711
Phone number: 269-925-0585
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