Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801088483 | MI |
NPI | 1003028226 |
---|---|
Provider Name | Mrs. Judy Lynn Muncey |
First Address | Livonia, MI 48150-3940 |
Second Address | Ann Arbor, MI 48108-3231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 02/04/2014 |