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NPI Code Detail

MEDICARE: MEGHAN LAUREN MAGDALENIC

MEDICARE: MEGHAN LAUREN MAGDALENIC
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 WorkerMI

General Provider Information

NPI Number : 1689012338
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGHAN LAUREN MAGDALENIC
Provider Business Mailing Address
First Line : 30000 HIVELEY ST
Second Line :
City : INKSTER
State : MI
Zip : 48141-1089
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 30000 HIVELEY ST
Second Line :
City : INKSTER
State : MI
Zip : 48141-1089
Country : US
Telephone Number : 734-728-3400
Fax Number : 734-728-3500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2013
Last Update Date : 06/04/2013

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Directions to “ MEGHAN LAUREN MAGDALENIC ” Practice Location

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