Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801072251 | MI |
NPI | 1003098450 |
---|---|
Provider Name | Ms. Cynthia A Joseph |
First Address | Saginaw, MI 48602-4236 |
Second Address | Saginaw, MI 48602-4236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2007 |
Last Update Date | 28/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
257178 | COMPSYCH (01) | MI |