Individual
MICHAEL WILKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3330 CLAYSTONE ST SE, GRAND RAPIDS, MI 49546-7738
(616) 949-7460
Mailing address
812 PINNACLE RUN DR SE, GRAND RAPIDS, MI 49546-8342
(313) 505-4793
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401015302
MI
106H00000X
Marriage & Family Therapist
4101006677
MI
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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