Mr Douglas Alan Wilson, MA, LPC | |
17224 Van Wagoner Rd, Spring Lake, MI 49456-9702 | |
(231) 799-8182 | |
(616) 296-2148 |
Full Name | Mr Douglas Alan Wilson |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 17224 Van Wagoner Rd, Spring Lake, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174833750 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 6401012170 (Michigan) | Primary |
Entity Name | Kristine Koetje Ma, Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316010770 PECOS PAC ID: 3375701873 Enrollment ID: O20120229000489 |
Mailing Address | Practice Location Address |
---|---|
Mr Douglas Alan Wilson, MA, LPC 17224 Van Wagoner Rd, Spring Lake, MI 49456-9702 Ph: (231) 799-8182 | Mr Douglas Alan Wilson, MA, LPC 17224 Van Wagoner Rd, Spring Lake, MI 49456-9702 Ph: (231) 799-8182 |
Mr. Mark E Olsen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 17224 Van Wagoner Rd, Spring Lake, MI 49456 Phone: 616-296-2130 | |
Kyle John-arthur Parcher, Counselor Medicare: Not Enrolled in Medicare Practice Location: 17224 Van Wagoner Rd, Spring Lake, MI 49456 Phone: 616-296-2130 | |
Leeanna April Peter, LLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 17224 Van Wagoner Rd, Spring Lake, MI 49456 Phone: 616-296-2130 | |
Amanda Vergin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 N Buchanan St, Spring Lake, MI 49456 Phone: 586-924-0125 | |
Dana Leigh Hood, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 17214 Van Wagoner Rd, Spring Lake, MI 49456 Phone: 231-670-0663 | |
Ms. Gretchen Lawrence, LPC Counselor Medicare: Medicare Enrolled Practice Location: 109 S Jackson St, Spring Lake, MI 49456 Phone: 616-842-0405 Fax: 616-842-0405 |