Individual
ELLEN WEGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC SLP
Contact information
Practice address
4467 BYRON CENTER AVE SW, GRAND RAPIDS, MI 49519-4808
(616) 552-9544
Mailing address
150 MAYFIELD AVE NE, GRAND RAPIDS, MI 49503-3767
(248) 860-6895
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA21384
FL
Other
Enumeration date
06/14/2022
Last updated
04/03/2024
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