Individual
MARY JO BAWEJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLP
Contact information
Practice address
889 143RD AVE, WAYLAND, MI 49348-9758
(616) 821-1575
Mailing address
889 143RD AVE, WAYLAND, MI 49348-9758
(616) 821-1575
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6361001393
MI
Other
Enumeration date
04/09/2022
Last updated
04/09/2022
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