Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 6801092196 | MI |
NPI | 1003252487 |
---|---|
Provider Name | Sara Gellner |
First Address | Howell, MI 48843-7885 |
Second Address | Howell, MI 48843-7885 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2013 |
Last Update Date | 03/08/2021 |