Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | MI |
NPI | 1588016877 |
---|---|
Provider Name | Scott Biskup |
First Address | Saginaw, MI 48602-3106 |
Second Address | Saginaw, MI 48602-3106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2016 |
Last Update Date | 11/07/2016 |