Healthcare Provider Details

I. General information

NPI: 1558920900
Provider Name (Legal Business Name): RHIANNA COMPTON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 W LAKE ST
ALPENA MI
49707-2216
US

IV. Provider business mailing address

PO BOX 655
ALPENA MI
49707-0655
US

V. Phone/Fax

Practice location:
  • Phone: 989-358-3998
  • Fax: 989-358-3735
Mailing address:
  • Phone: 989-736-9815
  • Fax: 989-358-3734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801104561
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: