Individual
DEANO BRUCE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LBSW
Contact information
Practice address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 745-4900
Mailing address
44227 DUCHESS DR, CANTON, MI 48187-3241
(734) 981-4423
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6802079722
MI
Other
Enumeration date
04/30/2013
Last updated
04/30/2013
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