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Individual

TATUM DAYE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
534 FOUNTAIN ST NE, GRAND RAPIDS, MI 49503-3422
(616) 456-1178
Mailing address
4374 VALLA CT SW, GRANDVILLE, MI 49418-2452
(567) 525-0050

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362009546
MI

Other

Enumeration date
08/18/2021
Last updated
10/21/2025
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