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Individual

DR. JANICE M DELANGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D. MSW

Contact information

Practice address
1514 WEALTHY ST SE, SUITE 260, GRAND RAPIDS, MI 49506-2755
(616) 451-3008
(616) 451-3070
Mailing address
1514 WEALTHY ST. SE, SUITE 260, GRAND RAPIDS, MI 49506
(616) 957-8159
(616) 451-3070

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6801066023
MI
101YM0800X
Mental Health Counselor
LW00006285
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
243116000
MAGELLAN MIS #
MI
01
7744301
AETNA ID #
MI
Enumeration date
10/18/2006
Last updated
07/08/2007
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