Provider Information for 1538606074
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MARY SMITH LMSW
Sex: Female
NPI: 1538606074
Last Updated: 2024-08-29
Certification Date: 2024-08-29
Certification Date: 2024-08-29
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1538606074 | ||||||||
| Enumeration Date | 2017-01-23 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 9315 TELEGRAPH RD REDFORD, MI 48239-1260 United States Phone: 313-937-9500 | Fax: | ||||||||
| Primary Practice Address | 9315 TELEGRAPH RD REDFORD, MI 48239-1260 United States Phone: 313-937-9500 | Fax: | ||||||||
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