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NPI 1518232248

NPI 1518232248 : ANGELA KAY LANDRUM LLPC : LANSING, MI

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General NPI Number Information
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    NPI Number           |    1518232248
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    Entity Type          |    Individual 
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    Provider Name        |    ANGELA KAY LANDRUM LLPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/13/2012
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    Last Update Date     |    03/13/2012
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Provider Practice Location Address
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    Address Line         |    416 ELMSHAVEN DR 
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    City                 |    LANSING
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    State                |    MI
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    Zip                  |    48917-3513
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    Country              |    US
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    Telephone            |    517-898-2513
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1254 
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    City                 |    EAST LANSING
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    State                |    MI
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    Zip                  |    48826-1254
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    Country              |    US
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    Telephone            |    517-898-2513
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    6401012844
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    License Number State |    MI
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