Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | MI |
NPI | 1164928115 |
---|---|
Provider Name | Patricia Scott |
First Address | Detroit, MI 48208-1006 |
Second Address | Detroit, MI 48208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2018 |
Last Update Date | 30/03/2018 |