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4999 Herron Rd Herron MI 49744-9600 | |
(989) 358-5700 | |
Not Available |
Full Name | |
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Speciality | Social Worker - Clinical |
Location | 4999 Herron Rd, Herron, Michigan |
Authorized Official Name and Position | Elizabeth Goddard (INS CREDENTIALING) |
Authorized Official Contact | 9897369815 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4999 Herron Rd Herron MI 49744-9600 Ph: (989) 358-5700 | 4999 Herron Rd Herron MI 49744-9600 Ph: (989) 358-5700 |
NPI Number | 1760888002 |
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Provider Enumeration Date | 11/14/2014 |
Last Update Date | 11/14/2014 |
Identifier | Type | State | Issuer |
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1760888002 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | 6801088331 (Michigan) | Primary |