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Individual

ALLEN WINEBARGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
509 FRANKLIN AVE, GRAND HAVEN, MI 49417-1400
(616) 844-4140
(616) 604-1437
Mailing address
509 FRANKLIN AVE, GRAND HAVEN, MI 49417-1400
(616) 844-4140
(616) 604-1437

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
6301010934
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0G04527
BCBS PROVIDER #
MI
01
6301010934
PSYCHOLOGIST LICENSE #
MI
Enumeration date
03/04/2007
Last updated
03/17/2025
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