Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 4450186 | MI |
NPI | 1003339821 |
---|---|
Provider Name | Mr. Sherrodd Eugene Rison |
First Address | Flint, MI 48503-2445 |
Second Address | Flint, MI 48503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2017 |
Last Update Date | 24/07/2017 |