Organization
LAURA MEEKER WICKSALL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA MEEKER WICKSALL (OWNER/THERAPIST)
(231) 499-1063
Entity
Organization
Contact information
Practice address
1430 ROBINSON RD SE STE 206, GRAND RAPIDS, MI 49506-1780
Mailing address
1430 ROBINSON RD SE STE 206, GRAND RAPIDS, MI 49506-1780
(616) 438-6054
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710390372
INDIVIDUAL
MI
Enumeration date
11/07/2018
Last updated
11/07/2018
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