Emanuel T. Vanbolden, Phd, Lp, Pc

NPI 1013217660 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1013217660
Enumeration Date 10/29/2010
Last Updated 10/29/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name EMANUEL T. EMANUEL
Position OWNER
Phone (313) 577-2840
Fax (313) 577-8949
Practice Location
60 FARNSWORTH ST
DETROIT MI, 48202-4060, US
Phone (313) 577-2840
Fax (313) 577-8949
Business Location
42335 WOODWARD AVE
BLOOMFIELD HILLS MI, 48304-5040, US
Phone
Fax
Toxanomy
Taxonomy Code 251S00000X
License State Michigan
License Number 6301013909
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According to our database, Emanuel T. Vanbolden, Phd, Lp, Pc NPI is 1013217660, taxonomy code is 251S00000X and license number is 6301013909, license state is located at Michigan. Emanuel T. Vanbolden, Phd, Lp, Pc physically located at 60 Farnsworth St, Detroit MI, 48202-4060. NPI Number 1033115704 has the healthcare provider type.

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1013217660 NPI number is provided on an as is basis without warranty of any kind. 1013217660 is maintained by the National Plan & Provider Enumeration System. The contents of Emanuel T. Vanbolden, Phd, Lp, Pc are for informational purposes only.