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General NPI Number Information
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NPI Number | 1114365277
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Entity Type | Individual
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Provider Name | ANGELA NICOLE OSHKALOFF
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Gender | Female
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 08/02/2019
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Provider Practice Location Address
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Address Line | 6594 PERRYVILLE RD
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City | HOLLY
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State | MI
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Zip | 48442-9499
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Country | US
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Telephone | 586-212-5677
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Fax |
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Provider Business Mailing Address
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Address Line | 6594 PERRYVILLE RD
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City | HOLLY
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State | MI
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Zip | 48442-9499
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Country | US
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Telephone | 586-212-5677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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