Individual
MRS. DEBRA LYNN WINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
309 HURON AVE, PORT HURON, MI 48060-3869
(810) 689-9899
Mailing address
820 EDISON BLVD, PORT HURON, MI 48060-2116
(810) 650-6205
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801019767
MI
Other
Enumeration date
05/01/2020
Last updated
05/01/2020
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