Healthcare Provider Details

I. General information

NPI: 1194694133
Provider Name (Legal Business Name): J WETZEL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8031 MAIN ST STE 304
DEXTER MI
48130-1150
US

IV. Provider business mailing address

8031 MAIN ST STE 304
DEXTER MI
48130-1150
US

V. Phone/Fax

Practice location:
  • Phone: 734-724-9660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAIME WETZEL
Title or Position: OWNER/PSYCHOLOGIST
Credential: PHD
Phone: 734-724-9660