Individual
MS. HEATHER L WYNIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4304
(616) 456-1443
(616) 732-6392
Mailing address
40 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4304
(616) 456-1443
(616) 732-6392
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801094696
MI
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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