Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6801107176 | MI |
NPI | 1003425737 |
---|---|
Provider Name | Miss Eilidh Fiona Sture |
First Address | Kalamazoo, MI 49007-2581 |
Second Address | Kalamazoo, MI 49007-2581 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2020 |
Last Update Date | 07/06/2021 |