Provider Demographics
NPI:1609640879
Name:VAN ES, ISABELLE GRACE
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:GRACE
Last Name:VAN ES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ISABELLE
Other - Middle Name:GRACE
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1897 TOSCANA ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-5303
Mailing Address - Country:US
Mailing Address - Phone:269-290-6177
Mailing Address - Fax:
Practice Address - Street 1:1897 TOSCANA ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-5303
Practice Address - Country:US
Practice Address - Phone:269-290-6177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician