Individual
AMANDA SONG HEE VANDENBUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
2045 E WEST MAPLE RD, SUITE D-407, COMMERCE TOWNSHIP, MI 48390-3801
(248) 624-3811
(248) 624-0368
Mailing address
114 ORCHARD LAKE RD, PONTIAC, MI 48341-2244
(248) 858-7766
(248) 858-7201
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401011593
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1883825
—
MI
Enumeration date
05/25/2010
Last updated
05/25/2010
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