Individual
KRISTINE ELIZABETH WILMOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LLP
Contact information
Practice address
700 HAMMOND RD E STE 200, TRAVERSE CITY, MI 49686-8641
(231) 947-2255
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301014161
MI
103TC0700X
Clinical Psychologist
6301014161
MI
Other
Enumeration date
11/07/2013
Last updated
11/27/2024
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