Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801021694 | MI |
NPI | 1003108655 |
---|---|
Provider Name | Ms. Susan K Patterson |
First Address | Saline, MI 48176-9773 |
Second Address | Saline, MI 48176-9773 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2011 |
Last Update Date | 13/05/2011 |