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NPI Code Detail

MEDICARE: SANDRA DUQUE LMSW

MEDICARE:   SANDRA  DUQUE  LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker
2104100000XSocial Worker6801090278MI

General Provider Information

NPI Number : 1629233952
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA DUQUE LMSW
Provider Business Mailing Address
First Line : 1660 FORT ST
Second Line :
City : TRENTON
State : MI
Zip : 48183-2003
Country : US
Telephone Number : 734-304-4159
Fax Number : 734-304-4162
Provider Business Practice Location Address
First Line : 1660 FORT ST
Second Line :
City : TRENTON
State : MI
Zip : 48183-2003
Country : US
Telephone Number : 734-304-4159
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2008
Last Update Date : 02/14/2025

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Directions to “ SANDRA DUQUE LMSW” Practice Location

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