Individual
AUDREY JOY-BAKER VANDER WAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
2305 E PARIS AVE SE STE 203, GRAND RAPIDS, MI 49546-2426
(616) 816-1758
(616) 333-7685
Mailing address
184 GLENDALE ST, HOLLAND, MI 49423-3031
(719) 310-4557
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401223152
MI
Other
Enumeration date
09/18/2020
Last updated
04/26/2024
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