Individual
TROY MICHAEL MASENGALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 GREEN ST, BATTLE CREEK, MI 49014-4028
(269) 965-1148
Mailing address
22579 N ULDRIKS DR, BATTLE CREEK, MI 49017-9069
(269) 830-4060
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401015341
MI
101YA0400X
Addiction (Substance Use Disorder) Counselor
6401015341
MI
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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