Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6801094559 | MI |
NPI | 1003162439 |
---|---|
Provider Name | Bridgette Anna Nanni |
First Address | Clinton Twp, MI 48038-5510 |
Second Address | Clinton Twp, MI 48038-5510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2012 |
Last Update Date | 08/05/2014 |