Provider Demographics
NPI:1295049203
Name:CRANG, MICHELLE ANN (LLP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:CRANG
Suffix:
Gender:
Credentials:LLP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ANN
Other - Last Name:YAX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLP
Mailing Address - Street 1:7 CAMBRIDGE PARK
Mailing Address - Street 2:
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-9779
Mailing Address - Country:US
Mailing Address - Phone:616-401-8908
Mailing Address - Fax:
Practice Address - Street 1:7 CAMBRIDGE PARK
Practice Address - Street 2:
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-9779
Practice Address - Country:US
Practice Address - Phone:616-401-8908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361006864103T00000X
MI6301010831103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty