Individual
SANDY IMANSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1411 LINCOLNWAY W, MISHAWAKA, IN 46544-1626
(574) 255-5669
(574) 537-2652
Mailing address
PO BOX 809, GOSHEN, IN 46527-0809
(574) 533-1234
(574) 537-2652
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
33002493A
IN
101YM0800X
Mental Health Counselor
6801018351
MI
Other
Enumeration date
06/12/2006
Last updated
02/11/2014
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