Provider Demographics
NPI:1144592023
Name:VANSTEE, JOSHUA TODD (MA)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:TODD
Last Name:VANSTEE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 E LAKE MITCHELL DR
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-9685
Mailing Address - Country:US
Mailing Address - Phone:231-944-0882
Mailing Address - Fax:
Practice Address - Street 1:815 E LAKE MITCHELL DR
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-9685
Practice Address - Country:US
Practice Address - Phone:231-944-0882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL12115042235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist