Individual
BIANCA FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BLSW
Contact information
Practice address
4318 MILLER RD, FLINT, MI 48507-1267
(810) 249-9924
Mailing address
8759 CLINTON MACON RD, CLINTON, MI 49236-9569
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6802090549
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6802090549
BLSW
—
Enumeration date
10/02/2019
Last updated
10/02/2019
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