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Individual

GREGORY WALTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
29500 SOUTHFIELD RD, SOUTHFIELD, MI 48076-2030
(248) 765-1795
Mailing address
4936 WOOD ST, WATERFORD, MI 48329-3479
(541) 554-7808

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704314350
MI

Other

Enumeration date
10/09/2021
Last updated
10/09/2021
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