Individual
ERIN E WIECZOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2100 RAYBROOK ST. SE, STE 203, GRAND RAPIDS, MI 49546
(616) 956-9440
(616) 954-1520
Mailing address
2100 RAYBROOK ST. SE, STE 203, GRAND RAPIDS, MI 49546
(616) 954-1558
(616) 954-3400
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6802082638
MI
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
774508891
—
MI
Enumeration date
04/27/2006
Last updated
02/11/2022
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