Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6401012702 | MI |
N | 104100000X | Social Worker | 6802085554 | MI |
NPI | 1003111204 |
---|---|
Provider Name | Mrs. Phyllis J Scripsick |
First Address | Van Buren Twp, MI 48111-5369 |
Second Address | Livonia, MI 48150-1646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2011 |
Last Update Date | 10/12/2021 |