| Marie Wilson, Llc | |
|
647 Gladstone Dr Se East Grand Rapids MI 49506-2818 | |
| (616) 475-7722 | |
| Not Available |
| Full Name | Marie Wilson, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 647 Gladstone Dr Se, East Grand Rapids, Michigan |
| Authorized Official Name and Position | Marie Wilson (OWNER) |
| Authorized Official Contact | 6164757722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marie Wilson, Llc 647 Gladstone Dr Se East Grand Rapids MI 49506-2818 Ph: (616) 475-7722 | Marie Wilson, Llc 647 Gladstone Dr Se East Grand Rapids MI 49506-2818 Ph: (616) 475-7722 |
| NPI Number | 1669213070 |
|---|---|
| Provider Enumeration Date | 06/03/2024 |
| Last Update Date | 04/18/2025 |
| Certification Date | 03/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669213070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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