Individual
ALLYSSA VAN WIENEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 STEVENS ST SW, GRAND RAPIDS, MI 49507-1526
(855) 832-6727
Mailing address
6392 TYLER ST, HUDSONVILLE, MI 49426-9497
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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