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General NPI Number Information
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NPI Number | 1184309130
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Entity Type | Individual
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Provider Name | VRUNDA PATEL TLLP
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Gender | Female
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 1055 GEZON PKWY SW
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City | WYOMING
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State | MI
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Zip | 49509-9542
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Country | US
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Telephone | 616-773-2908
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Fax |
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Provider Business Mailing Address
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Address Line | 2352 PRAIRIE PKWY SW APT 106
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City | WYOMING
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State | MI
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Zip | 49519-2583
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Country | US
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Telephone | 847-666-7603
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6362009729
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License Number State | MI
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