Individual
ANIDA NINA FAZIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
507 36TH ST SE, WYOMING, MI 49548-2339
(616) 247-4580
(616) 247-4590
Mailing address
585 JEWETT RD, MASON, MI 48854-8729
(517) 676-5405
(517) 676-5460
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801093668
MI
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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