Individual
DE'ANGELO VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7705
Mailing address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7705
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
104100000X
Social Worker
6851109642
MI
1041C0700X
Clinical Social Worker
6801109642
MI
Other
Enumeration date
06/28/2021
Last updated
12/21/2022
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