Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801095705 | MI |
NPI | 1003243536 |
---|---|
Provider Name | Alan Strong |
First Address | Kalamazoo, MI 49006-2997 |
Second Address | Kalamazoo, MI 49006-2997 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2013 |
Last Update Date | 08/03/2021 |