Dr. Anthony Edward Gensterblum, PhD
Psychologist, Clinical in Jackson, MI. Individual provider (NPI-1).
NPI number1619255635
StatusActive
Last updated in NPPESJul 25, 2011
Details
- NPI
- 1619255635
- Entity type
- Individual (NPI-1)
- Name
- Dr. Anthony Edward Gensterblum
- Credential
- PhD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 25, 2011
- Last updated
- Jul 25, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 6301011915 | MI | Yes |
| 1041C0700X | Social Worker, Clinical | 6801060063 | MI |
Practice location
505 Wildwood AveJackson, MI 49201-1012
Phone 517-783-4418 · Fax 517-783-4504
Mailing address
505 Wildwood AveJackson, MI 49201-1012
Phone 517-783-4418 · Fax 517-783-4504
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