Individual
CHARMAIN ROSE ZAPOTOCZNY LA FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
6 PARKLANE BLVD, SUITE 695, DEARBORN, MI 48126-2696
(313) 271-8170
Mailing address
6 PARKLANE BLVD., SUITE 695, DEARBORN, MI 48126
(313) 271-8170
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8008970120
BCBSM
MI
Enumeration date
01/08/2007
Last updated
12/09/2014
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