Individual
MRS. VALERIE WIETEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2505 ARDMORE ST SE, GRAND RAPIDS, MI 49506-4924
(616) 822-9051
(616) 559-1056
Mailing address
1020 BROWNWOOD AVE NW, GRAND RAPIDS, MI 49504-3651
(616) 822-9051
(616) 559-1056
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
L529610
MI
Other
Enumeration date
10/07/2014
Last updated
04/14/2015
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