MEDICARE: JENNA SUZANN WIERENGA PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6301015873	MI

General Provider Information

NPI Number	:	1477783843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA SUZANN WIERENGA PSYD

Provider Business Mailing Address
First Line	:	3924 SUPERIOR ST SW
Second Line	:
City	:	GRANDVILLE
State	:	MI
Zip	:	49418-1641
Country	:	US
Telephone Number	:	616-403-2407
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 CANAL AVE SW
Second Line	:	STE M
City	:	GRANDVILLE
State	:	MI
Zip	:	49418-2667
Country	:	US
Telephone Number	:	616-403-2407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2009
Last Update Date	:	03/25/2016

Similar Medicare Providers

1326902362 — ERIN LAMBRIGHT
Practice Location Address:

4301 CANAL AVE SW STE 201B
GRANDVILLE, MI
49418-2667

Practice Phone: 616-202-6560
Practice Fax:

1346360799 — ERICA L DMUCHOSKI WRIGHT AU.D.
Practice Location Address:

4301 CANAL AVE SW , SUITE #203
GRANDVILLE, MI
49418-2667

Practice Phone: 616-257-7880
Practice Fax: 616-257-0580

1205056314 — THE HEARING CLINIC, INC
Practice Location Address:

4301 CANAL AVE SW , SUITE 203
GRANDVILLE, MI
49418-2667

Practice Phone: 616-257-7880
Practice Fax: 616-257-0580

1265697320 — SANDY L SIAN
Practice Location Address:

4301 CANAL AVE SW
GRANDVILLE, MI
49418-2667

Practice Phone: 616-257-7880
Practice Fax: 616-257-0580

1871988758 — LEE CHASSEE
Practice Location Address:

4301 CANAL AVE SW STE M
GRANDVILLE, MI
49418-2667

Practice Phone: 616-953-0721
Practice Fax:

1447798434 — JETTIE VELTHOUSE
Practice Location Address:

4301 CANAL AVE SW # M
GRANDVILLE, MI
49418-2667

Practice Phone: 616-222-0631
Practice Fax:

Directions to “ JENNA SUZANN WIERENGA PSYD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.