Individual
MS. PATRICIA LYNN DEWENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2875 UNION CT SE, WYOMING, MI 49548-1223
(616) 301-5742
(616) 457-1087
Mailing address
2875 UNION CT SE, WYOMING, MI 49548-1223
(616) 301-5742
(616) 457-1087
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6801062496
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801062496
STATE LICENSE
MI
Enumeration date
11/17/2006
Last updated
07/08/2007
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