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General NPI Number Information
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NPI Number | 1033022983
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Entity Type | Individual
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Provider Name | REBEKAH WISNESKI
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Gender | Female
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 100 BETTY ST NE
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City | COMSTOCK PARK
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State | MI
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Zip | 49321-9116
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Country | US
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Telephone | 616-254-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 750 GRACELAND ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49505-4258
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Country | US
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Telephone | 616-272-9469
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 6801117504
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License Number State | MI
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