Individual
DANIELLE WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
4069 LAKE DR SE, SUITE 315, GRAND RAPIDS, MI 49546-8816
(616) 267-7758
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000732
MI
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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