Individual
BRYAN R WISDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
233 FULTON ST E STE 28, GRAND RAPIDS, MI 49503-3262
(616) 228-9244
Mailing address
928 N MAIN ST, ELKHART, IN 46514-2736
(859) 402-3795
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4101007405
MI
Other
Enumeration date
10/18/2021
Last updated
07/17/2025
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