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Individual
MRS. KERI A PANTALE
Active
Individual
MRS. KERI A PANTALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801086826
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
774349006
—
MI
Enumeration date
12/18/2006
Last updated
05/15/2014
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