Individual
HEIDI CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1055 GEZON PKWY SW, WYOMING, MI 49509-9542
(616) 773-2908
Mailing address
4152 CHAMINADE DR SW, GRANDVILLE, MI 49418-2589
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
MI
133V00000X
Registered Dietitian
01029214
MI
Other
Enumeration date
04/15/2013
Last updated
04/29/2026
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