| |
2021 Monroe St, Dearborn, MI 48124-2926 | |
(517) 245-4778 | |
(517) 698-8223 |
Full Name | |
---|---|
Type | Facility |
Speciality | Community/behavioral Health |
Location | 2021 Monroe St, Dearborn, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548814551 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Heather L Guernsey |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1508510454 PECOS PAC ID: 8820471642 Enrollment ID: I20220811001662 |
Provider Name | Carol Woodyard |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1932848686 PECOS PAC ID: 3274997069 Enrollment ID: I20230912003703 |
Mailing Address | Practice Location Address |
---|---|
Po Box 12279, Lansing, MI 48901-2279 Ph: (517) 245-4778 | 2021 Monroe St, Dearborn, MI 48124-2926 Ph: (517) 245-4778 |