| Limited License Social Worker | |
|
2799 W Grand Blvd Detroit MI 48202-2608 | |
| (313) 874-4316 | |
| Not Available |
| Full Name | Limited License Social Worker |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2799 W Grand Blvd, Detroit, Michigan |
| Authorized Official Name and Position | Thomas Nantais (COO) |
| Authorized Official Contact | 3138744316 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Limited License Social Worker 1 Ford Pl Ste 2e Detroit MI 48202-3450 Ph: (313) 874-4316 | Limited License Social Worker 2799 W Grand Blvd Detroit MI 48202-2608 Ph: (313) 874-4316 |
| NPI Number | 1700313723 |
|---|---|
| Provider Enumeration Date | 05/22/2017 |
| Last Update Date | 05/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700313723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Michigan) | Primary |
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