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1861560195
TIMOTHY CHARLES ROSENBOOM
CASSOPOLIS, MI
NPI
1861560195
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MI 140001)
Enumeration Date
2006-12-04
Last Update Date
2007-07-08
Business Address
Mr. TIMOTHY CHARLES ROSENBOOM M. Div.
960 E STATE ST
CASSOPOLIS, MI 49031-9339
Phone number: 269-476-9781
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Mailing Address
Mr. TIMOTHY CHARLES ROSENBOOM M. Div.
8848 KEPHART LN
BERRIEN SPRINGS, MI 49103-1440
Phone number: 269-471-1955
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