Disselkoen, Mary

Disselkoen, Mary is an individual health care provider with primary practice located at 1353 Van Auken St Se , Grand Rapids MI 49508-2516. She recently has 3 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist, Speech, Language and Hearing Service Providers / Assistive Technology Practitioner, Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Disselkoen, Mary can be contacted via phone (616) 819-2685.

Contact Information

Primary practice address
1353 Van Auken St Se Grand Rapids MI 49508-2516
Phone: (616) 819-2685
Fax: (616) 819-2684
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 1601000230 Michigan
Speech, Language and Hearing Service Providers / Assistive Technology Practitioner 231HA2400X 1601000230 Michigan
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X 1601000230 Michigan

Profile Details

NPI number 1457596090
LBN Legal business name Disselkoen, Mary
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2008
Last updated Dec 11th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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