Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801066459 | MI |
NPI | 1003133158 |
---|---|
Provider Name | Heather Joy Spotts |
First Address | Laingsburg, MI 48848-9203 |
Second Address | Lansing, MI 48848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2010 |
Last Update Date | 29/04/2010 |