Individual
LAUREN ELIZABETH WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
92 N BRIDGE ST, SARANAC, MI 48881-5102
(616) 642-6466
Mailing address
3274 SANDCREST ST SW, GRANDVILLE, MI 49418-1477
(616) 304-2599
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451019727
MI
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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