Healthcare Provider Details

I. General information

NPI: 1578979571
Provider Name (Legal Business Name): ANGELA MARIE ALLMEN LMSW, IMH-E(III)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA MARIE BEDZ LMSW, IMH-(E)III

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 FAST ICE DR
MIDLAND MI
48642-6167
US

IV. Provider business mailing address

218 FAST ICE DR
MIDLAND MI
48642-6167
US

V. Phone/Fax

Practice location:
  • Phone: 989-631-2320
  • Fax: 989-631-9903
Mailing address:
  • Phone: 989-631-2320
  • Fax: 989-631-9214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801097374
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: