Doctor Name: | BHUMI NAGLE |
NPI Number: | 1568761583 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 6401015079 |
Business Practice Address: | 26522 Van Dyke Ave Center Line, MI - 480151221 |
Business Phone Number: | 5867594400 |
Business Fax Number: | |
Mailing Address: | 6549 Town Center Dr Ste A, CLARKSTON |
State: | MI |
Postal Code: | 483464824 |
Phone Number: | 3177889769 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2011 |
NPI Last Update Date: | 11/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401015079 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |