Individual
ELLYN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1113 W SUPERIOR ST, WAYLAND, MI 49348-1228
(616) 252-6711
Mailing address
1113 W SUPERIOR ST, WAYLAND, MI 49348-1228
(616) 252-6711
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801104219
MI
Other
Enumeration date
06/21/2017
Last updated
08/05/2026
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