Provider Demographics
NPI:1134895378
Name:DANGLER, ROBERT J (MA,LLPC,QMHP)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:DANGLER
Suffix:
Gender:M
Credentials:MA,LLPC,QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 PICKETT RD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:MI
Mailing Address - Zip Code:49269-9610
Mailing Address - Country:US
Mailing Address - Phone:517-937-3364
Mailing Address - Fax:
Practice Address - Street 1:125 SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-4920
Practice Address - Country:US
Practice Address - Phone:734-219-3314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional