Individual
AMANDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4597
(616) 685-2700
Mailing address
2557 FOX RUN RD SW APT 1, WYOMING, MI 49519-4121
(616) 690-7379
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
MI
Other
Enumeration date
06/26/2025
Last updated
06/26/2025
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