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626 Reed Ave Kalamazoo MI 49001-2971 | |
| (269) 343-6653 | |
| (269) 343-0054 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 626 Reed Ave, Kalamazoo, Michigan |
| Authorized Official Name and Position | Lorinda June Anderson (DIRECTOR QA) |
| Authorized Official Contact | 2693436355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
626 Reed Ave Kalamazoo MI 49001-2971 Ph: (269) 343-6355 | 626 Reed Ave Kalamazoo MI 49001-2971 Ph: (269) 343-6653 |
| NPI Number | 1366957516 |
|---|---|
| Provider Enumeration Date | 12/11/2017 |
| Last Update Date | 12/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366957516 | NPI | - | NPPES |
| AS390073055 | Other | MI | LICENSE NUMBER |
| AS390317402 | Other | MI | LICENSE NUMBER |
| AS390092832 | Other | MI | LICENSE NUMBER |
| AS390291227 | Other | MI | LICENSE NUMBER |
| AS390250889 | Other | MI | LICENSE NUMBER |
| AS390011418 | Other | MI | LICENSE NUMBER |
| AS390011445 | Other | MI | LICENSE NUMBER |
| AS390011454 | Other | MI | LICENSE NUMBER |
| AS390366234 | Other | MI | LICENSE NUMBER |
| AS390015350 | Other | MI | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 6802046743 (Michigan) | Primary |
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