Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6802087635 | MI |
NPI | 1003341207 |
---|---|
Provider Name | Karen Larabell |
First Address | Livonia, MI 48152-1444 |
Second Address | Livonia, MI 48152-1444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2017 |
Last Update Date | 25/04/2017 |