Organization
AMY L. WIDENBAUM, LMSW, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY L WIDENBAUM LMSW (CLINICAL THERAPIST)
(248) 568-9680
Entity
Organization
Contact information
Practice address
18420 FARMINGTON RD, LIVONIA, MI 48152-3588
(248) 568-9680
(734) 425-6212
Mailing address
18420 FARMINGTON RD, LIVONIA, MI 48152-3588
(248) 568-9680
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801066237
MI
Other
Enumeration date
05/16/2008
Last updated
08/26/2013
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