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General NPI Number Information
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NPI Number | 1114696838
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Entity Type | Individual
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Provider Name | JANNA VANDERBAND ATR-P
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Gender | Female
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 3800 LAKE MICHIGAN DR NW STE 103
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City | GRAND RAPIDS
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State | MI
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Zip | 49534-4583
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Country | US
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Telephone | 616-805-3680
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 11TH ST NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-4311
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Country | US
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Telephone | 616-821-8274
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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