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1083377980
BRYAN R WISDOM
GRAND RAPIDS, MI
NPI
1083377980
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: MI 4151001031)
Enumeration Date
2021-10-18
Last Update Date
2021-10-18
Business Address
BRYAN R WISDOM LLMFT
233 FULTON ST E STE 28
GRAND RAPIDS, MI 49503-3262
Phone number: 616-228-9244
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Mailing Address
BRYAN R WISDOM LLMFT
928 N MAIN ST
ELKHART, IN 46514-2736
Phone number: 859-402-3795
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