Individual
LISA MARIE WALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
3054 S 9TH ST STE B, KALAMAZOO, MI 49009-6250
(269) 743-6139
Mailing address
2739 ARROWWOOD LN, KALAMAZOO, MI 49004-3713
(269) 744-1160
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401018643
MI
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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