Individual
DR. ANTHONY EDWARD GENSTERBLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
505 WILDWOOD AVE, JACKSON, MI 49201-1012
(517) 783-4418
(517) 783-4504
Mailing address
505 WILDWOOD AVE, JACKSON, MI 49201-1012
(517) 783-4418
(517) 783-4504
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301011915
MI
1041C0700X
Clinical Social Worker
6801060063
MI
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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