Provider Demographics
NPI:1174213045
Name:PASMOOIJ, MABELLE
Entity type:Individual
Prefix:
First Name:MABELLE
Middle Name:
Last Name:PASMOOIJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 THOMPSON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-7204
Mailing Address - Country:US
Mailing Address - Phone:650-245-9098
Mailing Address - Fax:
Practice Address - Street 1:330 THOMPSON ST APT 2
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-7204
Practice Address - Country:US
Practice Address - Phone:650-245-9098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician