Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801078391 | MI |
NPI | 1003100785 |
---|---|
Provider Name | Mrs. Ann Martin Schueller |
First Address | Canton, MI 48187-1310 |
Second Address | Plymouth, MI 48170-1615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2011 |
Last Update Date | 14/07/2020 |