| Basshamdbt Llc | |
|
200 Elm St Ste 200d Birmingham MI 48009-6322 | |
| (248) 986-2991 | |
| (248) 294-1237 |
| Full Name | Basshamdbt Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 200 Elm St Ste 200d, Birmingham, Michigan |
| Authorized Official Name and Position | Kelly Michael Bassham (CEO) |
| Authorized Official Contact | 2489862991 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Basshamdbt Llc 200 Elm St Ste 200d Birmingham MI 48009-6322 Ph: (248) 986-2991 | Basshamdbt Llc 200 Elm St Ste 200d Birmingham MI 48009-6322 Ph: (248) 986-2991 |
| NPI Number | 1174280002 |
|---|---|
| Provider Enumeration Date | 11/28/2021 |
| Last Update Date | 11/28/2021 |
| Certification Date | 11/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174280002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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