Organization
INTEGRATIVE PSYCHOTHERAPY, PLC
Active
Other names
IP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C. WEIKS ED.D. (OWNER)
(616) 822-9714
Entity
Organization
Contact information
Practice address
2707 BRETON RD SE, GRAND RAPIDS, MI 49546-5633
(616) 822-9714
Mailing address
2707 BRETON RD SE, GRAND RAPIDS, MI 49546-5633
(616) 822-9714
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301004073
MI
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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