Individual
JASMINE MICHELLE BANEGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
5716 MICHIGAN AVE STE 4100, DETROIT, MI 48210-3039
(313) 963-2266
Mailing address
5716 MICHIGAN AVE STE 4100, DETROIT, MI 48210-3039
(313) 963-2266
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801102168
MI
Other
Enumeration date
01/17/2018
Last updated
01/23/2018
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