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Individual
MS. MICHAL SAMUEL
Active
Individual
MS. MICHAL SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW MA
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301012583
MI
1041C0700X
Clinical Social Worker
Primary
6301012583
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000986-4086
AETNA
MI
01
—
0960542
BLUE CROSS BLUE SHIELD
MI
01
—
453758
TRICARE
—
01
—
600074425
MAGELLAN
MI
Enumeration date
05/02/2007
Last updated
10/05/2012
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