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General NPI Number Information
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NPI Number | 1205564531
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Entity Type | Organization
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Legal Business Name | STANGE CLINIC, PC
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Dates
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Enumeration Date | 08/14/2022
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 2305 E PARIS AVE SE STE 203
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2426
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Country | US
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Telephone | 616-816-1758
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Fax | 616-333-7685
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Provider Business Mailing Address
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Address Line | 7150 ARMADALE CT NE
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City | BELMONT
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State | MI
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Zip | 49306-9690
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Country | US
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Telephone | 586-764-6671
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. TORY SEIF
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Credential | PH.D.
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Telephone | 616-916-6680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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