Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801090333 | MI |
NPI | 1003164823 |
---|---|
Provider Name | David Julian Hopkins |
First Address | Oak Park, MI 48237-3007 |
Second Address | Oak Park, MI 48237-3007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2012 |
Last Update Date | 28/08/2012 |