| Gayle Witham | |
|
558 Winona Ave Nw Grand Rapids MI 49504-4740 | |
| (616) 477-3404 | |
| Not Available |
| Full Name | Gayle Witham |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 558 Winona Ave Nw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Gayle Witham (SOCIAL WORK) |
| Authorized Official Contact | 6164773404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gayle Witham 558 Winona Ave Nw Grand Rapids MI 49504-4740 Ph: (616) 477-3404 | Gayle Witham 558 Winona Ave Nw Grand Rapids MI 49504-4740 Ph: (616) 477-3404 |
| NPI Number | 1255780979 |
|---|---|
| Provider Enumeration Date | 06/03/2016 |
| Last Update Date | 06/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255780979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801085993 (Michigan) | Primary |
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