Provider Information for 1477089829
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HEATHER RAITZ LMSW
Sex: Female
NPI: 1477089829
Last Updated: 2019-12-30
Certification Date: 2019-12-30
Certification Date: 2019-12-30
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1477089829 | ||||||||
| Enumeration Date | 2017-05-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 206 OAKSTREET ROCHESTER, MI 48307 United States Phone: 248-840-6996 | Fax: | ||||||||
| Primary Practice Address | 38600 VAN DYKE AVE STE 101 STERLING HEIGHTS, MI 48312-1171 United States Phone: 586-566-3020 | Fax:586-566-3055 | ||||||||
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