Most Relevant Information
Provider Data
| NPI Number: | 1003474560 |
| Provider Name: | MICHELLE VANDENBERG LLMSW; BLS |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/30/2019 |
| Last Updated: | 05/30/2019 |
Provider Practice Location
2925 BRETON RD SE
GRAND RAPIDS
MI
495121745
Practice Location Phone/Fax
| Phone: | 6162434336 |
| Fax: |
Provider Mailing Location
2925 BRETON RD SE
GRAND RAPIDS
MI
495121745
Provider Mailing Phone/Fax
| Phone: | 6162434336 |
| Fax: |