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Individual
LAURALEE REA
Active
Individual
LAURALEE REA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801089086
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211715928
—
MI
Enumeration date
03/15/2011
Last updated
03/31/2015
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