Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6801097338 | MI |
NPI | 1003347139 |
---|---|
Provider Name | Jennifer Hirsch |
First Address | Midland, MI 48640-4555 |
Second Address | Midland, MI 48640-4555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2017 |
Last Update Date | 21/03/2017 |