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Individual
Inactive
Individual
Inactive
Sole proprietor
Provider details
NPI number
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801015071
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01002573
HEALTH PLUS OF MICHIGAN
MI
01
—
1007731
MCLAREN HELATH PLAN
MI
01
—
1705242
BCBSM
MI
Enumeration date
—
Last updated
—
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