Individual
CAITLYN WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2020 RAYBROOK ST SE, GRAND RAPIDS, MI 49546-7717
(616) 202-4444
Mailing address
1522 COLE AVE NE APT 2, GRAND RAPIDS, MI 49505-5027
(989) 390-2561
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6451022295
MI
Other
Enumeration date
06/28/2022
Last updated
07/13/2022
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