Organization
WILSON AND WYNN INTERVENTIONS, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA JEAN WYNN-STELT (CO-OWNER)
(616) 647-3460
Entity
Organization
Contact information
Practice address
4519 CASCADE RD SE STE 6, GRAND RAPIDS, MI 49546-8319
(616) 647-3460
Mailing address
10843 CRAWFORD LAKE TRL, CEDAR SPRINGS, MI 49319-8771
(616) 647-3460
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6301008405
MI
101YM0800X
Mental Health Counselor
6301012332
MI
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
6301008405
MI
103TM1800X
Intellectual & Developmental Disabilities Psychologist
6301012332
MI
1041C0700X
Clinical Social Worker
6801083017
MI
Other
Enumeration date
01/24/2007
Last updated
02/06/2023
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