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Individual

MRS. AMANDA MICHELLE WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
7330 BISCAYNE WAY SE, GRAND RAPIDS, MI 49546-9705
(616) 915-5614
Mailing address
7330 BISCAYNE WAY SE, GRAND RAPIDS, MI 49546-9705
(616) 915-5614

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
242.000562
IL
235Z00000X
Speech-Language Pathologist
Primary
7101001622
MI

Other

Enumeration date
07/28/2007
Last updated
03/28/2017
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