| Doctor Name: | AMY M KANDELL |
| NPI Number: | 1225048143 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 6301011344 |
| Business Practice Address: | 3847 Pine Grove Ave Suite A Fort Gratiot, MI - 480594265 |
| Business Phone Number: | 8109842250 |
| Business Fax Number: | |
| Mailing Address: | 2971 Maywood Dr, PORT HURON |
| State: | MI |
| Postal Code: | 480607719 |
| Phone Number: | 8109820919 |
| Fax Number: | |
| NPI Enumeration Date: | 08/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 6301011344 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |