| NPI | 1730484163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JAMES VANGEL Sole Proprietor 248-842-2930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301009301) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301009301) |
| 103TR0400X Psychologist, Rehabilitation (Licence: MI 6301009301) | |
| Enumeration Date | 2011-01-15 |
| Last Update Date | 2011-01-15 |