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NPI Code Detail

MEDICARE: MRS. MAUREEN TARA ANGELI LLPC

MEDICARE: MRS. MAUREEN TARA ANGELI LLPC
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
1101YM0800XMental Health Counselor6401009917MI

General Provider Information

NPI Number : 1528346186
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MAUREEN TARA ANGELI LLPC
Provider Business Mailing Address
First Line : 8105 ORCHARDVIEW DR
Second Line :
City : WASHINGTON TWP
State : MI
Zip : 48095-1345
Country : US
Telephone Number : 586-531-8642
Fax Number :
Provider Business Practice Location Address
First Line : 1410 E 14 MILE RD
Second Line :
City : MADISON HEIGHTS
State : MI
Zip : 48071-1541
Country : US
Telephone Number : 248-524-8850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2011
Last Update Date : 08/01/2011

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