Individual
ANNETTE H PRESCOD-BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 324-3535
Mailing address
1640 FORT STREET, SUITE D ATTN DENISE, TRENTON, MI 48183
(734) 391-3057
(734) 391-3052
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801086953
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H21692
BLUE CROSS
MI
01
—
1093940272
GROUP NPI HENRY FORD WYANDOTTE
—
Enumeration date
01/16/2013
Last updated
04/11/2018
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