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Individual

AMY VANZANDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC, CAADC

Contact information

Practice address
15209 W MICHIGAN AVE, MARSHALL, MI 49068-9570
(269) 781-9119
Mailing address
15209 W MICHIGAN AVE, MARSHALL, MI 49068-9570
(269) 781-9119

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
103TC0700X
Clinical Psychologist
6401009406
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6401009406
LICENSE NUMBER
MI
Enumeration date
09/22/2015
Last updated
03/11/2019
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