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1194376053
ELLEN MARY MANEGOLD
GRAND RAPIDS, MI
NPI
1194376053
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: MI 6301018734)
Enumeration Date
2019-09-23
Last Update Date
2021-02-25
Business Address
ELLEN MARY MANEGOLD PhD
35 MICHIGAN ST NE STE 5201
GRAND RAPIDS, MI 49503-2530
Phone number: 616-267-2830
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Mailing Address
ELLEN MARY MANEGOLD PhD
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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