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NPI Code Detail

MEDICARE: ANGELA JOERIN M.S.

MEDICARE:   ANGELA  JOERIN  M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist6301015152MI

General Provider Information

NPI Number : 1184987299
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA JOERIN M.S.
Provider Business Mailing Address
First Line : 5186 LINDHOLM DR
Second Line :
City : WHITE LAKE
State : MI
Zip : 48383-1829
Country : US
Telephone Number : 248-935-6366
Fax Number :
Provider Business Practice Location Address
First Line : 5186 LINDHOLM DR
Second Line :
City : WHITE LAKE
State : MI
Zip : 48383-1447
Country : US
Telephone Number : 248-935-6366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2012
Last Update Date : 06/22/2012

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Directions to “ ANGELA JOERIN M.S.” Practice Location

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