Individual
ANN MARIE BLACKTOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
611 E MAIN ST, HART, MI 49420-1190
(231) 873-5675
(231) 873-4805
Mailing address
611 E MAIN ST, HART, MI 49420-1190
(231) 873-5675
(231) 873-4805
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
AB033570
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383119096
TAX ID
MI
01
—
8008974220
BCBS
MI
01
—
800F410320
BCBSMI
MI
Enumeration date
07/05/2006
Last updated
05/22/2009
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