Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801046155 | MI |
NPI | 1003254095 |
---|---|
Provider Name | Mrs. Janet Lynn Hughes |
First Address | Traverse City, MI 49686-5924 |
Second Address | Traverse City, MI 49686-5924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2013 |
Last Update Date | 12/06/2013 |