Individual
MRS. JENNIFER ANN WISNIEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.L.P.
Contact information
Practice address
2090 CELEBRATION DR NE STE 212, GRAND RAPIDS, MI 49525-9200
(616) 307-8385
Mailing address
3333 RYPENS DR NW, WALKER, MI 49534-2463
(616) 307-8385
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301013497
MI
Other
Enumeration date
10/05/2008
Last updated
10/05/2008
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