Provider Demographics
NPI:1114546173
Name:VANANDEL, AIMEE (LLP)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:VANANDEL
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 E ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-1941
Mailing Address - Country:US
Mailing Address - Phone:231-239-1819
Mailing Address - Fax:
Practice Address - Street 1:646 E ORCHARD DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-1941
Practice Address - Country:US
Practice Address - Phone:231-239-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-10
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist