Individual
ANDRE JAMAR WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
TLLP
Contact information
Practice address
610 S BURDICK ST, KALAMAZOO, MI 49007-5221
(269) 381-3700
(269) 381-3810
Mailing address
610 S BURDICK ST, KALAMAZOO, MI 49007-5221
(269) 381-3700
(269) 381-3810
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301013835
MI
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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