Individual
DAN GAUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
O-1859 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49534-9578
(616) 677-5251
Mailing address
O-1859 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49534-9578
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
10/24/2014
Last updated
10/24/2014
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