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Organization

CEDAR TREE

Active
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Organization

CEDAR TREE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JON WILLIAM MAGNUSON MSW ACSW (DIRECTOR)
(906) 228-5494
Entity
Organization

Contact information

Practice address
403 E MICHIGAN ST, MARQUETTE, MI 49855-3827
(906) 228-5494
(906) 228-5494
Mailing address
403 E MICHIGAN ST, MARQUETTE, MI 49855-3827
(906) 228-5494
(906) 228-5494

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801070289
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1245299601
DIRECTORS NPI NUMBER
MA
Enumeration date
01/13/2007
Last updated
08/22/2020
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