Individual
AUTUMN DE SILVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 BAILEY ST, EAST LANSING, MI 48823-4444
(517) 565-4475
Mailing address
2190 AURELIUS RD UNIT 82, HOLT, MI 48842-5503
(517) 565-4475
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801100447
MI
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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