Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6801095697 | MI |
NPI | 1003207911 |
---|---|
Provider Name | Hilary Consiglio |
First Address | Grand Rapids, MI 49503-1138 |
Second Address | Grand Rapids, MI 49503-1138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2015 |
Last Update Date | 13/02/2015 |