Individual
HAUTUMN VANGEISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3611 HENRY ST, NORTON SHORES, MI 49441-4705
(760) 805-6399
Mailing address
116 TULGEYWOOD LANE, WHITEHALL, MI 49461
(760) 805-6399
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401015731
MI
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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