Individual
MRS. JEANNETTE ANN AGNELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA., L.L.P.
Contact information
Practice address
1424 E 11 MILE RD, ROYAL OAK, MI 48067-2026
(248) 548-4044
(248) 548-9239
Mailing address
5776 CELICO LN, DRYDEN, MI 48428-9201
(586) 662-9600
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301013681
MI
103TC0700X
Clinical Psychologist
6301013681
MI
Other
Enumeration date
10/02/2007
Last updated
08/19/2014
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