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Individual

MR. BRUCE ALAN TABASHNECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMSW, ACSW, MI

Contact information

Practice address
29865 6 MILE RD, SUITE 112, LIVONIA, MI 48152-3673
(734) 522-0280
Mailing address
2856 CENTRAL ST, BERKLEY, MI 48072-2153
(248) 207-2165

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801015055
MI
1041S0200X
School Social Worker
6801015055
MI

Other

Enumeration date
06/17/2006
Last updated
07/18/2008
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