Organization
EMANUEL T. VANBOLDEN, PHD, LP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMANUEL T. VANBOLDEN PHD (OWNER)
(248) 333-1083
Entity
Organization
Contact information
Practice address
60 FARNSWORTH ST, DETROIT, MI 48202-4060
(313) 577-2840
(313) 577-8949
Mailing address
42335 WOODWARD AVE, BLOOMFIELD HILLS, MI 48304-5040
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6301013909
MI
Other
Enumeration date
10/29/2010
Last updated
10/29/2010
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