Individual
EVONNE M EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
4211 PARKWAY PL SW, GRANDVILLE, MI 49418-2695
(616) 222-3700
(616) 222-3707
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301014805
MI
103T00000X
Psychologist
Primary
6301015324
MI
Other
Enumeration date
06/17/2011
Last updated
10/02/2012
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