Individual
MARIE VANTUBBERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2205 COMMONWEALTH BLVD, ANN ARBOR, MI 48105-2970
(734) 936-9552
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 649-5299
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
6301012121
MI
103TC0700X
Clinical Psychologist
Primary
6301012121
MI
103TR0400X
Rehabilitation Psychologist
6301012121
MI
Other
Enumeration date
10/10/2008
Last updated
12/05/2019
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