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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