Individual provider · Type 1 NPI

Tatum Daye Wilson

Psychologist · Grand Rapids, MI

NPI number 1265108401 Active

Practice location

534 Fountain St NE
Grand Rapids, MI 49503-3422

Call (616) 456-1178 Map

Mailing address

4374 Valla Ct SW
Grandville, MI 49418-2452

Specialties and licenses

TaxonomyCodeLicense
Psychologist Primary 103T00000X6362009546 (MI)

Psychologist: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustmen…

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About NPI 1265108401

Tatum Daye Wilson's National Provider Identifier is 1265108401, issued on Aug 18, 2021. The primary taxonomy on file is Psychologist (103T00000X), and the practice location is in Grand Rapids, MI. The record was last updated on Oct 21, 2025.