Individual
DR. LUKE VANDER WAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
4211 PARKWAY PLACE DR SW, GRANDVILLE, MI 49418-2695
(616) 222-3700
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301019396
MI
103TC0700X
Clinical Psychologist
6351004490
MI
Other
Enumeration date
05/28/2020
Last updated
10/31/2023
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